Bemidji Area Tribes were some of the first to exercise their right to participate in PL-93-638 and only three of the thirty-four federally-recognized Tribes have Indian Health Service (IHS) Service Units. In a 2017 survey that GLITEC conducted among Bemidji Area IHS, Tribally-operated, or urban Indian health programs (ITUs), the 2nd most commonly used EHR/EMR was RPMS and survey respondents described wanting Resource Patient Management System (RPMS) training and education.

In April 2019, the Great Lakes Inter-Tribal Epidemiology Center co-hosted a RPMS training for Bemidji Area I/T/U clinical staff with the IHS regional Bemidji Area Office.

 

Eighty-seven percent of participants “agreed” or “strongly agreed” (n=15) that the training was valuable.

 

This training was made possible through the Centers for Disease Control and Prevention’s Building Public Health Infrastructure in Tribal Communities program.

 

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She was also an Injury Prevention Specialist with the Indian Health Service for the Fort Defiance District (26 Navajo Nation Chapters or local governments) for 9 years before returning to GIS to improve and increase her skills with GIS. As an Injury Prevention Specialist she has learned community-based project management with very small budgets and implementing comprehensive projects with evaluation and measures. She learned to “sell” her program as she was the only role in advocating for Injury Prevention to a sea of Environmental Health Specialists, community leaders, Injury Prevention stakeholders, and upper management. Indian Health Service provided many trainings and experiences in all aspects of a community-based injury prevention program. Of her many successful projects at the Fort Defiance District, she has facilitated injury prevention coalition meetings, implemented evaluations of fall prevention, passenger safety, and outreach activities, implemented surveys of passenger safety use, provided technical assistance in the passing of an updated Navajo Nation child passenger law, and maintained the severe injury data surveillance database. She has collaborated with various programs to partner in injury prevention efforts and leverage resources for under-funded objectives.

She is excited to work in the field of epidemiology as her interest grew after taking graduate courses at the University of Michigan in Epidemiology during an Injury Prevention Fellowship program.

Delores Becenti, Senior Programs and Projects Specialist for the Navajo Epidemiology Center.

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Elderly Fall Prevention

The Rocky Mountain Tribal Leaders Council, Epidemiology Center (RMTEC) has been working with the IHS Billings Area Office to implement an evidence-based program entitled A Matter of Balance, as a part of Elderly Fall Prevention.

 

A Matter of Balance program includes both an education and exercise component and is designed to reduce the fear of falling and increase the activity levels of older adults who have concerns about falls.

 

In November 2018, an employee from each office attended a training to become A Matter of Balance Master Trainers. As Master Trainers, their role is to train volunteer coaches in the Tribal communities, who will then go on to facilitate A Matter of Balance classes in their communities.

Recently, the Master Trainers held their first coach training, and six volunteers became certified as A Matter of Balance Coaches. These coaches plan to start their classes in late spring or early summer. The Master Trainers are excited to train more volunteers in the other Tribal communities and plan to have A Matter of Balance Coaches trained in each site by the end of summer 2019.

Kaylee Vandjelovic, Public Health Specialist at RMTEC and one of the Master Trainers, discussing A Matter of Balance program during the coach training.

The six new volunteer coaches with the Master Trainers, after completing the two-day training and earning their certificates.

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Over 95% of respondents from NWTEC’s survey indicated that they were enrolled members of a federally recognized tribe, with 60% of these respondents being enrolled members of an Oregon tribe. Respondents also represented a degree of geographic variance, as over half of Oregon’s counties were represented. Although health priorities could shift slightly when analyzing results by demographic characteristics, the top priorities remained relatively stable across the board. These top priorities selected were:

1. Safe, affordable housing
2. Access to mental health care
3. Substance use
4. Adverse childhood/life experiences (ACE/ALEs), trauma, and toxic stress
5. Living wage
6. Obesity
7. Suicide

These priorities of AI/AN residents closely match the five priorities that were selected by OHA’s steering committee, which includes:

1. Behavioral health (substance use, suicide, and access to mental health care)
2. Economic drivers of health (food insecurity, housing, transportation, living wage)
3. Adversity, trauma, and toxic stress (ACE/ALEs)
4. Equitable access to care
5. Institutional bias across private and public entities

Since AI/AN people were underrepresented in the community input that OHA used to write the current health plan (2015-2019 SHIP), targeted outreach by NWTEC and community participation helped insure that Native voices were clearly heard during the planning process.

If you have any questions or would like more information about NWTEC or Oregon’s SHIP process, please contact Taylor Ellis at tellis@npaihb.org.

 

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