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Exploring Effects of Climate Change on Northern Plains American Indian Health

ABSTRACT: American Indians have unique vulnerabilities to the impacts of climate change because of the links among ecosystems, cultural practices, and public health, but also as a result of limited resources available to address infrastructure needs. On the Crow Reservation in south-central Montana, a Northern Plains American Indian Reservation, there are community concerns about the consequences of climate change impacts for community health and local ecosystems. Observations made by Tribal Elders about decreasing annual snowfall and milder winter temperatures over the 20th century initiated an investigation of local climate and hydrologic data by the Tribal College. The resulting analysis of meteorological data confirmed the decline in annual snowfall and an increase in frost free days. In addition, the data show a shift in precipitation from winter to early spring and a significant increase in days exceeding 90° F (32° C). Streamflow data show a long-term trend of declining discharge. Elders noted that the changes are affecting fish distribution within local streams and plant species which provide subsistence foods. Concerns about warmer summer temperatures also include heat exposure during outdoor ceremonies that involve days of fasting without food or water. Additional community concerns about the effects of climate change include increasing flood frequency and fire severity, as well as declining water quality. The authors call for local research to understand and document current effects and project future impacts as a basis for planning adaptive strategies.

SUBMITTER: Doyle JT

PROVIDER: S-EPMC3831579 | biostudies-literature | 2013 Oct

REPOSITORIES: biostudies-literature

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"Exploring Effects of Climate Change on Northern Plains American Indian Health"

Doyle John T JT Redsteer Margaret Hiza MH Eggers Margaret J MJ

Climatic change 20131001 3

American Indians have unique vulnerabilities to the impacts of climate change because of the links among ecosystems, cultural practices, and public health, but also as a result of limited resources available to address infrastructure needs. On the Crow Reservation in south-central Montana, a Northern Plains American Indian Reservation, there are community concerns about the consequences of climate change impacts for community health and local ecosystems. Observations made by Tribal Elders about ...[more]

PMID: 24265512

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Project description:BackgroundBreast cancer is the most common cancer in the United States and the second leading cause of death for American Indian women. American Indian women have lower rates of breast cancer screening than other racial groups, and disparities in breast cancer mortality and survival rates persist among them. To address this critical need, a culturally appropriate, accessible, and personalized intervention is necessary to promote breast cancer screening among American Indian women. This study used mobile health principles to develop a mobile web app-based mammogram intervention (wMammogram) for American Indian women in a remote, rural community in the Northern Plains.ObjectiveThis study aimed to assess the feasibility and efficacy of the wMammogram intervention, which was designed to motivate American Indian women to undergo breast cancer screening, as compared with the control group, who received an educational brochure.MethodsUsing community-based participatory research (CBPR) principles and a multipronged recruitment strategy in a randomized controlled trial design, we developed the wMammogram intervention. This study involved 122 American Indian women aged between 40 and 70 years, who were randomly assigned to either the intervention group (n=62) or the control group (n=60). Those in the intervention group received personalized and culturally appropriate messages through a mobile web app, while those in the control group received an educational brochure. We measured outcomes such as mammogram receipt, intention to receive breast cancer screening after the intervention, and participants' satisfaction with and acceptance of the intervention.ResultsA significantly higher proportion of women who received the wMammogram intervention (26/62, 42%; P=.009) completed mammograms by the 6-month follow-up than the control group (12/60, 20%). The wMammogram intervention group, compared with the control group, reported significantly higher ratings on perceived effectiveness of the intervention (t120=-5.22; P<.001), increase in knowledge (t120=-4.75; P<.001), and satisfaction with the intervention (t120=-3.61; P<.001). Moreover, compared with the brochure group, the intervention group expressed greater intention to receive a mammogram in the future when it is due (62/62, 100% vs 51/60, 85%) and were more willing to recommend the intervention they received to their friends (61/62, 98.4% vs 54/60, 90%) with statistically significant differences.ConclusionsThis study shows the feasibility and efficacy of the wMammogram intervention to promote breast cancer screening for American Indian women in a remote, rural community-based setting. Findings suggest that, with advancements in technology and the ubiquity of mobile devices, mobile web apps could serve as a valuable health intervention tool that builds upon low-cost technology and enhances accessibility and sustainability of preventive care to help reduce breast health disparities experienced in hard-to-reach American Indian populations.Trial registrationClinicalTrials.gov NCT05530603; https://clinicaltrials.gov/ct2/show/NCT05530603.

Dataset Information

Exploring Effects of Climate Change on Northern Plains American Indian Health

Publications

"Exploring Effects of Climate Change on Northern Plains American Indian Health"

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