Communicating Native American Cancer Efforts and Resources in the Great Plains.

American Indians' cancer disparities vary by region, signifying the importance of understanding community-specific levels of readiness to address cancer. Twenty-four key respondents from an urban American Indian community in the Great Plains, community leaders (n = 8), educators (n = 8), and students (n = 8), were interviewed following the Community Readiness Model. Using framework analysis, we qualitatively examined data related to efforts and resources in interview transcripts. One overarching emergent theme and three subthemes were identified. We found that communication of efforts and resources is critical to increasing community readiness to address cancer and is most successful when the community (1) prioritizes cancer as an issue in the community, (2) cultivates trusting relationships among stakeholders, and (3) practices cultural responsiveness in efforts. These findings emphasize the need for better communication of cancer efforts and resources and can inform strategic efforts to promote cancer prevention, treatment, and research among American Indians/Alaska Natives in the Great Plains.

Urban American Indian Community Health Beliefs Associated with Addressing Cancer in the Northern Plains Region.

American Indians residing in the Northern Plains region of the Indian Health Service experience some of the most severe cancer-related health disparities. We investigated ways in which the community climate among an American Indian population in an urban community in the Northern Plains region influences community readiness to address cancer. A Community Readiness Assessment, following the Community Readiness Model, conducted semi-structured interviews with eight educators, eight students, and eight community leaders from the American Indian community in Omaha's urban American Indian population and established the Northern Plains region community at a low level of readiness to address cancer. This study reports on a subsequent qualitative study that analyzed all 24 interview transcriptions for emergent themes to help understand the prevailing attitude of the community toward cancer. A synthesis of six emergent themes revealed that the community's perceptions of high levels of severity and barriers, paired with perceptions of low levels of susceptibility and benefits, lead to low levels of self-efficacy, all of which are reflected in minimal cues to action and little effort to address cancer. These findings, interpreted through the lens of the Health Belief Model, can inform the development of more community-based, comprehensive, and culturally appropriate approaches to address the multilevel determinants of health behaviors in relation to cancer among American Indians in the Northern Plains region.

Profile of minority and under-served patients using acupuncture.

BACKGROUND: Acupuncture use remains common in the United States, yet little is known of its utilization by minority and underserved populations. Herein we report first visit data capturing patient profiles, types of conditions presented, and self-reports of their experience and satisfaction with acupuncture accessed at a free care clinic with in a large urban safety net hospital. METHODS: Sixty-one adult, English-speaking acupuncture patients were given a 20 min survey after their first visit to a free care acupuncture clinic. RESULTS: Patients were from 12 different countries. Fifty-six percent of the participants were minorities. Sixty-five percent of respondents were female. Average age was 42.1. Eighty percent were acupuncture naïve. Patients' health complaints were similar to those of other surveyed mainstream patients with 57% reporting musculoskeletal conditions. Ninety-three percent would recommend a friend or family for acupuncture, 97% rating their overall experience with the acupuncture clinic as either very good or good. CONCLUSIONS: When made available to a diverse population of patients, acupuncture is utilized and perceived to be helpful. In this survey, patients sought treatment for musculoskeletal conditions and were satisfied with their first visit. Future research is warranted.

Non-Insertive Acupuncture and Neonatal Abstinence Syndrome: A Case Series from an Inner City Safety Net Hospital.

OBJECTIVE: We report on the safety of non-insertive acupuncture (NIA) in 54 newborns diagnosed with Neonatal Abstinence Syndrome (NAS) in a busy inner city hospital. METHODS: For this case series, a retrospective chart review was conducted. Data on participant demographics, number of NIA treatments, provider referrals, and outcomes of interest (sleeping, feeding, and adverse events) were collected. RESULTS: Of the 54 newborns receiving NIA, 86% were non-Hispanic White; 87% were on Medicaid, and gestational age ranged from 33.2 to 42.1 weeks. Out of 54 chart reviews, a total of 92 NIA sessions were documented ranging from 1 to 6 sessions per infant. Of the total number of treatments (n = 92), 73% were requested by a physician. Chart reviews reported restless infants calmed down during NIA, babies slept through or fell asleep immediately following NIA, and better feeding was noted following NIA. There were no adverse events noted in the medical records. CONCLUSIONS: This retrospective chart review shows potential for the use of NIA as an adjunctive treatment in newborns with NAS symptoms during hospitalization. More research is necessary to study whether the incorporation of NIA can result in positive outcomes in newborns withdrawing from narcotics.

The real-time processing of sluiced sentences.

Ellipsis refers to an element that is absent from the input but whose meaning can nonetheless be recovered from context. In this cross-modal priming study, we examined the online processing of Sluicing, an ellipsis whose antecedent is an entire clause: The handyman threw a book to the programmer but I don't know which book the handyman threw to the programmer(ellipsis.) To understand such an elliptical construction, the listener arguably must 'fill in' the missing material ("the handyman threw___ to the programmer") based on that which occurs in the antecedent clause. We aimed to determine the point in time in which reconstruction of the sluiced sentence is attempted and whether such a complex antecedent is re-accessed by the ellipsis. Out of the two antecedent constituents for which we probed, only the Object (programmer) was found active in the elliptical clause, confirming that an antecedent is attributed to the sluice in real time. Possible reasons for the non-observation of the Subject (handyman) are considered. We also suggest that ellipses are detected earlier in coordinated than subordinated sentences.

If you build it, will they come? A free-care acupuncture clinic for minority adolescents in an urban hospital.

OBJECTIVE: To describe the establishment and integration of a free-care acupuncture clinic within an urban hospital with an underserved minority adolescent population and to study patient utilization. BACKGROUND: Surveys often show low use of acupuncture among underserved non-Asian minority populations. We hypothesized that it would be possible to integrate an acupuncture clinic into a biomedical setting. We also hypothesized that the removal of economic and logistical barriers would increase usage of an acupuncture service among minority adolescent and pediatric populations, who may otherwise have had little cultural exposure to the modality. METHODS: A review of the process involved in establishing a free acupuncture clinic, and an analysis of visit data. RESULTS: A free faculty-supervised student acupuncture clinic was successfully integrated into an urban hospital-based adolescent clinic serving predominantly low-income minorities. During 2004-2006, the acupuncture clinic had 544 visits for a wide range of conditions. Visits increased 65% from the first to the third year of operation. CONCLUSIONS: An acupuncture service can be successfully integrated into care provided by an urban hospital that serves low-income minority and immigrant patients. Strategic removal of barriers to access can result in patients previously unfamiliar with acupuncture choosing to access the modality.