Abstract
The COVID-19 pandemic is global in nature but especially threatens American Indian and Alaska Native (AI/AN) communities due to pre-existing conditions and social determinants of health. Because of the higher risk to AI/AN communities, many tribal nations have been proactive in their policies to keep the virus at bay, including travel restrictions and lockdowns. This affected tribal programs as well as collaborative research projects. One project impacted is the Native CHOICES project, an ongoing randomized controlled trial with an AI/AN community that is focused on the prevention of alcohol-exposed pregnancies. Originally designed to be conducted via in-person motivational interviewing sessions, COVID-19 restrictions precluded the intervention from being delivered in-person as it was designed. The study team received valuable input from the project’s Community Advisory Board (CAB) and community-based staff to establish a feasible and acceptable way of conducting the intervention while respecting tribally-enacted COVID-19 restrictions. The goal of this brief report is to outline not just the process to adapting to COVID-19 but also to provide recommendations for future public health programs, including the ongoing need to consider gaps in access affecting resource-poor settings.
Highlights
American Indian and Alaska Native (AI/AN) communities in the United States face a wide variety of health disparities, largely due to limited access to healthcare compared to the general population owing to healthcare systems that are underfunded and under-resourced, racism and discrimination in healthcare, a dearth of culturally-attuned services, and other access barriers such as transportation
The focus of public health interventions have shifted to the COVID-19 pandemic, which is global in nature but especially threatens AI/AN communities
One university-tribal partnership impacted by the COVID-19 pandemic is between researchers at Washington State University (WSU) and a tribe in the Great Plains of the United States
Summary
American Indian and Alaska Native (AI/AN) communities in the United States face a wide variety of health disparities, largely due to limited access to healthcare compared to the general population owing to healthcare systems that are underfunded and under-resourced, racism and discrimination in healthcare, a dearth of culturally-attuned services, and other access barriers such as transportation. The goal of this paper is to provide documentation of how one university-tribal partnership pivoted an in-person intervention to be completed remotely, and how the input of the community was invaluable to maintaining the momentum of the recruitment into the program. The introduction of the COVID-19 vaccination would theoretically make completing Native CHOICES inperson feasible, but slow uptake of the vaccination among rural communities as seen across the nation, as well as the increase of COVID-19 variants, means this university-community partnership continues remotely.
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