"Hecel Oyate Kin Nipi Kte -- So That The People May Live"
Protocols for collecting sensitive data from Native Americans November 18, 2016
CURRENT HEALTH CARE SERVICES FOR GREAT PLAINS REGION INDIAN HEALTH SERVICE (IHS) The Great Plains Area Office in Aberdeen, South Dakota works in conjunction with its 19 Indian Health Service Units and Tribal Managed Service Units, to provide health care to approximately 122,000 Native Americans located in North Dakota, South Dakota, Nebraska and Iowa. The Area Office s service units include seven hospitals, eight health centers, and several smaller health stations and satellite clinics. Tribes of North Dakota & South Dakota: Cheyenne River Sioux Tribe Flandreau Santee Sioux Tribe Oglala Lakota Nation Spirit Lake Dakota Nation Mandan, Hidatsa and Arikara Nation Yankton Sioux Tribe Crow Creek Sioux Tribe Lower Brule Sioux Tribe Rosebud Sioux Tribe Sisseton-Wahpeton Sioux Tribe Standing Rock Sioux Tribe Turtle Mountain Band of Chippewa
Great Plains Region Traditional medicine model: Important to understand holistic healing approach: Physical: Health, strength Emotional: Inner peace Mental: Self-concept, attitude Spiritual: balance and harmony Traditional Values: Praying, Honesty, Generosity, Wisdom, Compassion, Respect, Humility
Protocols: Do s and Don ts Avoid Stereotyping Cultural issues; Spirituality Belief system maybe traditional or Christian or mixture of both Language May speak fluently or know some or none of the language Skin color Dark skin (full-blood), lighter skin-color (half-mixed blood) may or may not know culture Healthcare Prefer traditional healing ceremonies to Western medical practices or practice both Strategy: Cultural Assessment for each client; basic questions regarding their cultural beliefs, values, lifestyle, etc.
Protocols Do s and Don ts Continued Religion and Spirituality Traditional Healing practices may include a medicine man/women, traditional ceremonies, traditional medicines Spiritual belief system: Traditional belief is tied to cultural awareness and practices on a daily basis. Bi-Cultural belief system is tied to both Traditional and Christian beliefs, values and lifestyle (ex. Ceremonies 1-2 times a year) Assimilated belief system is only with Christian belief or other Strategy Don t assume, when in doubt ask. (ex. Do you participate in traditional healing practices?)
Communication Protocols Do s and Don ts Continued Verbal: Rude to talk in a loud voice; Patients are listening even if they seem quiet or inattentive Declarative statements work best when working with patients Careful how use Positive or Negative ( Your test results were positive ) Non-Verbal Direct eye contact inappropriate (elders) Need for personal space (ex. Interviewing, assessments) Inappropriate to touch patient ( ex: Hair, hugs) Pain management: Stoic disposition, won t verbalize they re in pain
Protocols-Continued Assessments that have sensitive questions: Allow patient to read through questionnaire first to prepare to answer Ask if more comfortable with a family member or support person be with them. (ex. Language, belief system, values) Guide conversation: Adults; explain how and why collecting data and reassure patient will have access to the test results Youth: Confidentiality issues explain process for consent and release of information forms: (Exception birth control) Be confident and comfortable with asking the questions
Strategies 1. Take your time 2. Build rapport 3. Develop Trust 4. Incentives compliment cultural practices (gift cards, swag bags, snacks, water) 5. Be patient 6. Learn more about the culture in your area
HEALTH CARE PROVIDERS FOR NATIVE AMERICAN POPULATIONS Indian Health Service (IHS) Urban Indian Health Programs HEALTH CARE Tribal Health Programs Veterans Administration Medicine Men/Women
QUESTION & ANSWERS
Thank you GREAT PLAINS TRIBAL CHAIRMEN S HEALTH BOARD (GPTCHB) 1770 Rand Road Rapid City, SD 57702 Phone: 605.721.1922 ext. 111 Toll Free: 1.800.745.3466 Fax: 605.721.1932 Dee Le Beau-Hein@gptchb.org Email: dee.lebeau-hein@gptchb.org