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Henderson P.N.,Black Hills Center for American Indian Health
Nicotine and Tobacco Research | Year: 2016

Introduction: Little is known about the scope of the tribally manufactured cigarette market. This study illuminates the topic by examining the Master Settlement Agreement Compliance Tobacco Directories, regularly updated documents that list the cigarette manufacturers and brand families that can be legally sold within participating states. Methods: In July 2014, the latest Tobacco Directories were identified for 43 states and the District of Columbia. Colorado archival tobacco directories were extracted, by month since 2003. Tribal manufacturers and brands were identified in the directories and mapped by state. Results: A total of 11 tribal manufacturers and 39 tribal cigarette brand families were identified in publicly available tobacco directories. Total unique brands were tallied by state, ranging from 1 to 24 unique brands. Historical data from Colorado showed that tribal manufacturers, as a percentage of all manufacturers, increased from 3.2% in 2003 to 20.6% by mid-2014. Discussion: Analysis of Tobacco Directories offers an innovative approach to better understand the tribally manufactured cigarette market. More research is needed to understand reporting and compliance to the Tobacco Directories by manufacturers and retailers, and their usefulness as a research tool to the tobacco control community. Implications: This study aims to make three contributions to the literature: (1) identify tribal tobacco manufacturers and brands in the Master Settlement Agreement Compliance documents; (2) highlight the presence and scope of the tribally manufactured cigarette brands across the United States; and (3) observe any upward or downward trends in tobacco brands and manufacturers since the directories' implementation.

Yang J.,The University of Oklahoma Health Sciences Center | Zhu Y.,The University of Oklahoma Health Sciences Center | Cole S.A.,The Texas Institute | Haack K.,The Texas Institute | And 10 more authors.
Diabetes | Year: 2012

Cigarette smoking is a risk factor for type 2 diabetes. Genetic variants in the nicotinic acetylcholine receptor (nAChR) genes have been associated with smoking phenotypes and are likely to influence diabetes. Although each single variant may have only a minor effect, the joint contribution of multiple single nucleotide polymorphisms (SNPs) to the occurrence of disease may be larger. In this study, we conducted a gene-family analysis to investigate the joint impact of 61 tag SNPs in 7 nAChRs genes on insulin resistance and type 2 diabetes in 3,665 American Indians recruited by the Strong Heart Family Study. Results show that although multiple SNPs showed marginal individual association with insulin resistance and type 2 diabetes, only a few can pass adjustment for multiple testing. However, a gene-family analysis considering the joint impact of all 61 SNPs reveals significant association of the nAChR gene family with both insulin resistance and type 2 diabetes (both P < 0.0001), suggesting that genetic variants in the nAChR genes jointly contribute to insulin resistance and type 2 diabetes among American Indians. The effects of these genetic variants on insulin resistance and diabetes are independent of cigarette smoking per se. © 2012 by the American Diabetes Association.

Bowen D.J.,Boston University | Henderson P.N.,Black Hills Center for American Indian Health | Buchwald D.,University of Washington
Journal of Medical Internet Research | Year: 2012

Background: The rate of smoking commercial tobacco products among American Indian youth is double the rate for white youth. Interventions are needed to reduce this disparity. Objective: To test the feasibility of a Web-based intervention to influence attitudes toward and intentions about smoking cigarettes among American Indian youth who attended a Native summer camp in the Northern Plains. Methods: The study website, the SmokingZine, was originally developed and tested in Canadian youth, then adapted to be appropriate for American Indian youth. We conducted a randomized controlled trial to test the influence of exposure to the adapted SmokingZine website on smoking attitudes and behaviors among American Indian youth 12-18 years of age. Participants assigned to the intervention group were given access to the website for 1 hour per day during their camp experience and asked to sign in to the site and use it. Control group participants were not given access to the site. Results: A total of 52% of intervention youth signed in to the website at least once. Among nonsmokers, intentions to try a cigarette in the intervention group declined from 16% to 0%, and increased from 8% to 25% in the control group (P <.05). Compared with the control group, youth in the intervention group were more likely to help others quit (21 percentage point change in intervention versus no change in control; P <.05) and had less positive attitudes about the drug effects of smoking (-0.19 change in intervention versus 0.67 in control; P <.05). Conclusion: These data indicate that SmokingZine needs more long-term, rigorous investigation as a way to keep American Indian youth from becoming regular smokers. Because the intervention group could use computers only 1 hour per day, increasing access might result in more visits and a greater effect of the website on smoking behaviors. © Deborah J. Bowen, Patricia Nez Henderson, Jessica Harvill, Dedra Buchwald.

Goins R.T.,West Virginia University | Spencer S.M.,University of South Carolina | McGuire L.C.,Centers for Disease Control and Prevention | Goldberg J.,University of Washington | And 2 more authors.
Gerontologist | Year: 2011

Purpose:With a sample of American Indian adults, we estimated the prevalence of adult caregiving, assessed the demographic and cultural profile of caregivers, and examined the association between cultural factors and being a caregiver. This is the first such study conducted with American Indians.Design and Methods:Data came from a cross-sectional study of 5,207 American Indian adults residing on 2 closely related Lakota Sioux reservations in the Northern Plains and one American Indian community in the Southwest. Cultural factors included measures of cultural identity and traditional healing practices.Results:Seventeen percent of our sample reported being caregivers. In both the Northern Plains and Southwest, caregiving was positively correlated with younger age, being a woman, larger household size, attending and participating in Native events, and endorsement of traditional healing practices. In both regions, attendance and participation in Native events and engagement in traditional healing practices were associated with increased odds of caregiving after adjusting for covariates. Only in the Northern Plains did we find that speaking some Native language at home was associated with increased odds of being a caregiver. Examination of interaction terms indicated some sex differences in the association between cultural factors and caregiving in the Northern Plains but not in the Southwest.Implications:Our findings indicate that greater cultural identity and engagement in traditional healing practices are related to caregiving in American Indian populations. Caregiving research, intervention efforts, and caregiving programs and services in Native communities should pay special attention to the dynamics of culture and caregiving. © 2011 The Author.

Hoffman R.M.,University of New Mexico | Hoffman R.M.,New Mexico VA Health Care System | Li J.,New Mexico VA Health Care System | Henderson J.A.,Black Hills Center for American Indian Health | And 3 more authors.
American Journal of Public Health | Year: 2014

Objectives. We linked databases to improve identification of American Indians/ Alaska Natives (AI/ANs) in determining prostate cancer death and incidence rates. Methods. We linked prostate cancer mortality and incidence data with Indian Health Service (IHS) patient records; analyses focused on residents of HIS Contract Health Service Delivery Area (CHSDA) counties. We calculated age-adjusted incidence and death rates for AI/AN and White men for 1999 to 2009; men of Hispanic origin were excluded. Results. Prostate cancer death rates were higher for AI/AN men than for White men. Death rates declined for White men (û3.0% per year) but not for AI/AN men. AI/AN men had lower prostate cancer incidence rates than White men. Incidence rates declined among Whites (û2.2% per year) and AI/ANs (û1.9% per year). Conclusions. AI/AN men had higher prostate cancer death rates and lower prostate cancer incidence rates than White men. Disparities in accessing health care could contribute to mortality differences, and incidence differences could be related to lower prostate-specific antigen testing rates among AI/AN men.

Veazie M.,Phoenix Area Indian Health Service | Ayala C.,Centers for Disease Control and Prevention | Schieb L.,Centers for Disease Control and Prevention | Dai S.,Centers for Disease Control and Prevention | And 2 more authors.
American Journal of Public Health | Year: 2014

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. Results. Heart disease death rates were higher among AI/AN persons than Whites from 1999 to 2009 (1.21 times for UCOD, 1.30 times for MCOD). Disparities were highest in younger age groups and in the Northern Plains, but lowest in the East and Southwest. In AI/AN persons, MCOD rates were 84% higher than UCOD rates. From 1990 to 2009, UCOD rates declined among Whites, but only declined significantly among AI/AN persons after 2003. Conclusions. Analysis with improved race identification indicated that AI/AN populations experienced higher heart disease death rates than Whites. Better prevention and more effective care of heart disease is needed for AI/AN populations.

Kunitz S.J.,University of Rochester | Veazie M.,Health-U | Henderson J.A.,Black Hills Center for American Indian Health
American Journal of Public Health | Year: 2014

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. Most significant, rates in the Northern and Southern Plains have declined far less since 1949 to 1953 than those in the East, Southwest, or Pacific Coast. Data for Alaska are not available for the earlier period, so its trajectory of mortality cannot be ascertained. Socioeconomic measures do not adequately explain the differences and rates of change, but migration, changes in selfidentification as an AI/AN person, interracial marriage, and variations in health care effectiveness all appear to be implicated.

Spencer S.M.,University of South Carolina | Goins R.T.,Western Carolina University | Henderson J.A.,Black Hills Center for American Indian Health | Wen Y.,Black Hills Center for American Indian Health | Goldberg J.,University of Washington
Journal of the American Geriatrics Society | Year: 2013

Caregiving can have a profound effect on the health of the caregiver, yet research on caregiving among American Indians is limited. The purpose of this study was to examine the influence of caregiving on the health-related quality of life (HRQoL) of American Indians enrolled in the Education And Research Towards Health (EARTH) study. Participants in the EARTH study represented three different tribes in the Northern Plains and Southwestern regions of the United States who completed self-administered, computer-assisted questionnaires between 2003 and 2006. Participants were classified as caregivers if at least one adult relied on them for personal care or as non-caregivers (n = 3,736). Caregivers were further classified according to type; those caring for an adult with unspecified needs (CAU, n = 482) and those caring for an adult with mental or physical difficulties (CAD, n = 295). HRQoL was measured using the mental and physical health component scores of the Medical Outcomes Study 12-item Short-Form Health Survey. Regional differences emerged with regard to caregiver type. Across both regions, non-caregivers reported significantly better mental and physical health than CAD, and the health of participants classified as CAU did not differ from that of non-caregivers. The health of American Indian caregivers depends on the kind of care provided, but detailed measures of caregiving are necessary to understand how caregiving influences health. This has implications for the design of effective interventions in tribal communities. © 2013, The American Geriatrics Society.

Sinclair K.A.,University of Hawaii at Manoa | Bogart A.,Center for Health Studies | Buchwald D.,University of Washington | Henderson J.A.,Black Hills Center for American Indian Health
Diabetes Care | Year: 2011

OBJECTIVE - To estimate the prevalence of metabolic syndrome by age, sex, and diabetes status in Northern Plains and Southwest American Indians. RESEARCH DESIGN AND METHODS - Data for this analysis came from the Education and Research Toward Health (EARTH) study, a 5-year cross-sectional study of Southwest and Northern Plains American Indian adults. The National Cholesterol Education Program's Adult Treatment Panel III (NCEP/ATP III) guidelines were used to identify adults with metabolic syndrome. RESULTS - The age-adjusted prevalence of the metabolic syndrome was 49.8% among 4,457 participants aged 18-88 years. Age-adjusted prevalence was 42.4% for participants without diabetes and 86.6% for participants with diabetes. In participants aged <40 years, the overall prevalence of metabolic syndrome was 53.1%; 44.9% after excluding individuals with diabetes. CONCLUSIONS - This study confirms a high prevalence of the metabolic syndrome among Northern Plains and Southwest American Indians of all ages. © 2011 by the American Diabetes Association.

Muus K.J.,University of North Dakota | Baker-Demaray T.B.,University of North Dakota | Bogart T.A.,Center for Health Studies | Duncan G.E.,University of Washington | And 3 more authors.
Journal of Rural Health | Year: 2012

Purpose: Studies have shown that women who engage in high levels of physical activity have higher rates of cancer screening, including Papanicalaou (Pap) tests. Because American Indian (AI) women are at high risk for cervical cancer morbidity and mortality, we examined Pap screening prevalence and assessed whether physical activity was associated with screening adherence among AI women from 2 culturally distinct regions in the Northern Plains and the Southwest. Methods: A total of 1,979 AI women at least 18 years of age participating in a cross-sectional cohort study reported whether they received a Pap test within the previous 3 years. Physical activity level was expressed as total metabolic equivalent (MET) scores and grouped into quartiles. We used binary logistic regression to model the association of Pap testing and MET quartile, adjusting for demographic and health factors. Findings: Overall, 60% of women received a Pap test within the previous 3 years. After controlling for covariates, increased physical activity was associated with higher odds of Pap screening (OR = 1.1 per increase in MET quartile; 95% CI = 1.1, 1.2). Conclusions: This is the first study to examine physical activity patterns and receipt of cancer screening in AIs. While recent Pap testing was more common among physically active AI women, prevalence was still quite low in all subgroups. Efforts are needed to increase awareness of the importance of cervical cancer screening among AI women. © 2011 National Rural Health Association.

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