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Alaskan Indian and American Native Nurse/Doula training pro

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martin ginger

on 5 June 2014

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Transcript of Alaskan Indian and American Native Nurse/Doula training pro

Strengths in the community
Defining the Problem
Community
Historical Barriers
Collaborative Team Approach
intervention is team based and family oriented
Wraparound approach
Recruitment of Doulas through Chief Seattle Club, Seattle Indian Center, or United Indians of All Tribes Foundation
Nurse training (postpartum depression, breastfeeding and school readiness).
Social worker will bring together entire team for plan.
Ecological assessment (strengths and barriers for mother and is used to guide care plan) by social worker
Care meetings (Assessing health and mental health)
Role of Doula
(health, play and learn)
Community Displacement through talking circle
talking circles aims to address the lack of traditional forms of social support for AI/AN community members that have been disrupted by Urban Indian Relocation Programs.
Bi-weekly circles in Chief Seattle Club
talking circles uses the group process for developing direct, honest, and effective communication in a team or community
3 talking circles separated by age groups.
Address dangers of smoking in pregnant mothers
Age relevant issues per group
Intervention Design
Alaskan Native and American Indian Nurse/Doula training program
Justification for Focus of Prenatal and Early Childhood Intervention

Addressing disparities in Early Childhood in AI/AN
Problems with Prenatal and Parenting support to Native Women
Defining Place
Video
Outcomes and Evaluation
Outcomes and Evaluations
Significant disparities in health and other childhood outcomes for American Indian and Alaskan Native in King County
Western model only choice for pregnant women (Long & Curry, 1998)
Address social isolation and loss of social capital among AN/AI in urban areas.
First three years of a baby's life extremely important
Attachment theory and relationship between children and caregivers
Limited resources for pregnant women and mothers with children in the first three years of life
4 percent of public funds in Washington State that are intended for youth education and development are invested in the first three years of a child’s life
In King County, the infant mortality rate for children born to AI/AN mothers is 13.7 percent, compared to the 3.8 percent infant mortality rate for children born to White mothers (King County, 2014).
In fact, AI/AN children are three times as likely as White children to be placed in out-of-home care (Evans-Campbell, 2008, p. 116). In Washington State, an astonishing one out of every ten AI/AN children are in foster care (Roberts, 2005, pp. 24-25).
School Achievement gap
predominant Western medical model of childbirth and prenatal care often conflicts with the cultural beliefs and practices of American Indian/Alaska Native communities
For instance, only 66.5 percent AI/AN women receive prenatal care in their first trimester, compared to 83.1 percent of pregnant women in the total U.S. population
Doctors may be unintentionally reinforcing oppressive assimilation programs and historical traumas endured by AI/AN communities when they impose Western childbearing belief systems on AI/AN women
There are over 200 different tribal affiliations within the club
Importance of family
The Potlatch and the Canoe Journeys are two traditional cultural practices specific to the Northwest.
These traditions contribute to a family’s overall well being.
value children and future generations
Resiliency is a vital strength among the AI/AN community
AI/AN cultures are traditionally very collectivist societies, opposed to individualistic.
Importance of someone in the community doing the work
Throughout the years tribes of the Pacific Northwest have had to fight the government for the right to practice many of their cultural traditions.
Seattle sits on Duwamish land, yet the government does not recognize this tribe.
Relocation program, the struggle for cultural preservation, and the government’s use of tribal recognition
Place makes a fundamental base of people’s lifestyles and thoughts, and it impacts people every moment in diverse invisible and visible ways.
Even though the AI/AN population comprises less than 1 percent of the total King County population, this population has a significantly higher rate (13.7%) of infant mortality than other populations in King County
History of relocation, boarding schools, discrimination in King County.
Intervention Design
collaborative team approach and community support and connection through talking circles.
collaborative team approach is guided by wraparound philosophy of care and consists of the mother, nurse, doula and social worker
Circle divided: prenatal, early postpartum 0-18 months, and secondary postpartum 18-36 months
The Nurse-Led Doula Training Program will improve AI/AN community specific issues and disparities such as the achievement gap in education, community displacement, low birth weight, infant mortality, breast feeding, drug and alcohol use, and postpartum depression
Open questions and discussions from open group
Documenting experiences and implementing change
Community inclusion
Address low birth weight by addressing tobacco as the most modifiable risk factor.
Recorded by the Doula (between her and mother)
From birth to eight months, the child should be developing basic motor and sensory skills.
eight to eighteen months, the child begins to develop greater self-actualization and engage in tentative ventures away from the safety of the mother.
eighteen months to thirty six months child can use different items as needed and recognizes mother's moods.
Kindergarten readiness.
Full transcript