Time-to-Treatment for Myocardial Infarction: Barriers and Facilitators Perceived by American Indians in Three Regions.

Early recognition of acute myocardial infarction (MI), followed by prompt emergency care, improves patient outcomes. Among rural American Indian (AI) populations there are disparities in access to care for MI and processes of care, resulting in poor MI-related health outcomes compared to the general population. We sought to gain an understanding of barriers related to MI time-to-treatment delays using a qualitative approach.

Trends and disparities in stroke mortality by region for American Indians and Alaska Natives.

Objectives: We evaluated trends and disparities in stroke death rates for American Indians and Alaska Natives (AI/ANs) and White people by Indian Health Service region.

Methods: We identified stroke deaths among AI/AN persons and Whites (adults aged 35 years or older) using National Vital Statistics System data for 1990 to 2009. We used linkages with Indian Health Service patient registration data to adjust for misclassification of race for AI/AN persons.

Historical trends and regional differences in all-cause and amenable mortality among American Indians and Alaska Natives since 1950.

American Indian and Alaska Native (AI/AN) death rates declined over most of the 20th century, even before the Public Health Service became responsible for health care in 1956. Since then, rates have declined further, although they have stagnated since the 1980s. These overall patterns obscure substantial regional differences.

Trends and disparities in heart disease mortality among American Indians/Alaska Natives, 1990-2009.

Objectives: We evaluated heart disease death rates among American Indians and Alaska Natives (AI/ANs) and Whites after improving identification of AI/AN populations.

Methods: Indian Health Service (IHS) registration data were linked to the National Death Index for 1990 to 2009 to identify deaths among AI/AN persons aged 35 years and older with heart disease listed as the underlying cause of death (UCOD) or 1 of multiple causes of death (MCOD). We restricted analyses to IHS Contract Health Service Delivery Areas and to non-Hispanic populations.

Heart disease mortality among Alaska Native people, 1981-2007.

Objectives: Historically, Alaska Native (AN) people have exhibited low overall rates of heart disease mortality compared with the U.S. white (USW) population.

Adaptation of the OODA Loop to reduce postoperative nausea and vomiting in a high-risk outpatient oncology population.

Postoperative nausea and vomiting (PONV) remains a ubiquitous concern for surgical outpatients with published rates ranging from 14% to 80%. An evidence-based approach was used to reduce PONV in a high-risk adult outpatient oncology population. The Observe, Orient, Decide, and Act (OODA) Loop, a rapid cycle management strategy, was adapted for use in an outpatient surgery center with six ORs.

The use of sentinel injury deaths to evaluate the quality of multiple source reporting for occupational injuries.

Purpose: This study sought to develop an efficient method for evaluating the validity and completeness of routinely available sources of occupational injury fatality data.

Methods: Deaths due to falls from elevations, machinery, and electrocutions were selected as sentinel injuries likely to have occurred at work. Deaths from these injuries were identified from Maryland vital statistics over 7 years.

Network analysis as a tool for assessing and building community capacity for provision of chronic disease services.

A network analysis was conducted in spring 2000 by the Southwest Center for Health Promotion in the U.S.-Mexico border community of Douglas, Arizona.

Building community capacity around chronic disease services through a collaborative interorganizational network.

This article presents the findings of a study examining the evolution of a network of health and human service organizations operating in a rural community on the Southwest border. The aim of the network was to build the capacity of the community to provide chronic disease education, prevention, and treatment services by developing collaborative relationships among a broad range of organizations. The impetus for the effort was based on receipt of a Turning Point grant.