Research

The Development of an Intertribal Quality of Life Measure for Native American and Indigenous Populations

Native Americans represent a population in dire need of wellness attention (Herring, 1997; LaFramboise, 1988; Terrell, 1994). Studies have established that widespread disparities exist between Native Americans and other ethnic groups in the areas of health, mental health, and education, and can be attributed in large part, to a lack of culturally appropriate, standardized assessment instruments (Duran & Duran, 1995; Fiske, 2002; Krieger, 2001; United States Department of Health and Human Services, [UDHHS], 2001; Weaver, 2002). Dynamics such as social disadvantage, racism, and the impact of historical trauma on the Native American lifeworld, for example, directly impact the course of health and wellness throughout the lifespan; yet, these dynamics are rarely, if ever, considered within the context of assessment (APA, 2003; DHHS, 1999, 2001; Duran & Duran; Krieger; Rogler, 1999). As a result, Native Americans have the lowest levels of academic achievement and highest drop-out rates in the United States (U.S. Department of Education, 1991), face some of the highest rates of diabetes and obesity in the world (Wharton & Hampl, 2004), and have an average life expectancy that is six years less than the rest of the U. S. population (Indian Health Service [IHS], 2002). In fact, age-adjusted death rates are greater for Native Americans than the rest of the U.S. population for alcoholism (740% higher), suicide (190% higher), homicide (180% higher), injuries (340 % higher), and tuberculosis (500% higher; IHS, 2001). According to the U. S. Commission on Civil Rights (2004), the lack of culturally appropriate assessment measures is a primary cultural, social, and structural barrier that continues to limit Native American access to health care.

Given the enormity of social, health, and mental health problems, disparate access to resources, and ineffective health and mental health interventions experienced by Native peoples, it is not only worthwhile, but necessary, to develop a culturally-specific measure of wellness appropriate for use among indigenous populations (Sue & Zane, 1994, USDHHS, 2000; USDHHS, 2001). Thus, the goal of this study is to create the Native American Wellness Scale (NAWS), a measure designed to target strengths and vulnerabilities, and provide awareness of the effects of sociohistorical factors on five wellness domains: (a) physical well-being, (b) psychological well-being, (c) spiritual well-being, (d) emotional well-being, and (e) cultural well-being. A contextual model of Native American wellness (Alvarado, 2005) that is theoretically based on Native American postcolonial psychology (Duran & Duran, 1995) and historical trauma theory (Brave Heart & DeBruyn, 1998; Brave Heart-Jordan & DeBruyn, 1995; Duran & Duran; Duran, Duran, & Brave Heart, 1998; Jilek, 1981; Solomon, Kotler, & Mikulincer, 1988) will serve as the foundation for the development of the NAWS.

Early effective assessment permits limited resources to be utilized for designing and implementing front-end prevention strategies, as opposed to more costly back-end remediation. Thus, the Native American Wellness Scale (NAWS) ) may contribute to positive social change as follows. First, the measure will enhance social awareness of the impact of historical trauma on the psyche and lifeworld of Native American people. Second, it would allow service providers to create optimum interventions, accurate timelines, and health service deliverability. Third, use of the NAWS would foster a multidisciplinary approach to health and mental healthcare. The team approach could have an increased potential of affecting social change than when groups work in isolation. Fourth, utilization of the NAWS would serve to promote communication and trust between Native Americans and nonNative Americans, thereby increasing the likelihood of follow-through on health and mental health care (Oetzel, Duran, Lucero, Jiang, Novins, Manson, & Beals, 2006). Finally, current disparities in health and mental health could be reduced because the construct of measurement would be better defined.

Denise Alvarado, Ph.D Candidate Psychology -Research and Evaluation Walden University (319)627-3164 dalvarad@waldenu.edu

George Smeaton, Ph. D. Assistant Dean--Research and Evaluation College of Social, Behavioral, and Health Sciences Walden University (612)801-2310 george.smeaton@waldenu.edu

United States
Walden University College of Social, Behavioral, and Health Sciences Minneapolis, Minnesota, United States

Dissertation chair, members, and principal investigator

Denise Alvarado, Ph.D. Candidate Psychology - Research and Evaluation, Principal Investigator, Walden University

George Smeaton, Ph.D., Dissertation Committee Chair, Walden University

Stephanie Cawthon, Ph. D., Dissertation Committee Member, Walden University

William Disch, Ph. D., Dissertation Committee Member, Walden University

If you are of Native American, Alaskan Native, Native Hawaiian, or other indigenous background and would like to help make a difference in the delivery of health and mental healthcare for indigenous peoples, please consider volunteering as a research participant for the Native American Wellness Scale (NAWS) study. Complete the form below and you will be sent details via email.

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