American Indigenous Populations Research Articles

A Pilot Randomized Controlled Trial Evaluating Peer Recovery Coaches for Addiction Recovery among Indigenous Americans

Addiction is a common and devastating problem among many Indigenous American (IA) groups around the United States. Too few IA health care providers are available to deliver care in a way that leverages IA values and traditions to support addiction recovery. Peer Recovery Coaches (PRCs) are individuals who have lived experience of addiction and have received specialized training in helping others in recovery. IA PRCs hold significant potential in helping to fill the gap of culturally-specific support in addiction. In this feasibility trial, we recruited a total of 120 adult (≥19 years) IAs with a substance use disorder through Facebook advertisements. Ninety participants were randomized to the PRC (experimental) group which received support from PRC and 30 to the Attention-Control (AC) group which received support from research nurse. Both groups received weekly support for 12 weeks. Participants completed weekly surveys during the 12-week intervention and monthly surveys during a three-month follow-up phase. The two groups had similar quantities of alcohol consumed, days of alcohol use, and days of drug use except that the PRC group had fewer days of alcohol use in the first three weeks of the intervention phase (2.05 days v. 3.5 days, p=0.04). We found that “support and advocacy” was the most common intervention provided by the PRC. The PRC intervention was widely accepted and appreciated by individuals who completed the program with 79% of individuals giving positive feedback regarding the PRCs and the remaining 21% giving neutral feedback. This trial provides some insights upon which future trials can draw to further evaluate the potential of PRCs in this hard-to-reach population with a high level of need. Trials or programs that rely on national recruitment may be successful in reaching a sufficient number of individuals but they may lack the more intensive in-person capacity that will likely help with retention. Despite this limitation, the current pilot demonstrated that racially-concordant PRC services likely have a high degree of acceptability among IA populations. Future studies may draw on these findings by having trained IA coaches recruit and work with individuals in-person to assist with higher levels of retention.

The Social and Home Environment: Impacts of Determinants of Health on Atopic Dermatitis, Pathways Toward Solutions, and Unique Considerations for Rural and Remote North American Indigenous Populations

The Social and Home Environment: Impacts of Determinants of Health on Atopic Dermatitis, Pathways Toward Solutions, and Unique Considerations for Rural and Remote North American Indigenous Populations

The Social and Home Environment: Impacts of Determinants of Health on Atopic Dermatitis, Pathways Toward Solutions, and Unique Considerations for Rural and Remote North American Indigenous Populations

Disparities in environmental and social determinants of health (DOH) are associated with morbidity in atopic dermatitis (AD). The socioecological model (SEM) is a framework that can be applied to better understand how DOH impacts patients with AD. We include a case scenario of a remote Indigenous patient reflective of real-world situations of living with AD and examine relevant impact, gaps in knowledge, and further research needs. This review highlights a variety of social and environmental exposures as important DOH which must be addressed to achieve optimal management in AD. The "Rainbow model” is a modified framework to help illustrate how complex environmental and social forces impact both AD presentation and therapeutic success. However, practical applications and outcome metrics for health promotion are limited.1 An inter- and transdisciplinary approach is paramount to address the complex challenges associated with AD care, as well as multistakeholder approach integrating culturally-competent equitable health frameworks. This review underscores the importance of expanding the focus of AD management beyond basic science and clinical trials to recognize and address health disparities and to promote optimal health and well-being in patients with AD, and contributes a working approach to mapping the complex interventions and patient-oriented research needed using a focus on remote North American Indigenous patients affected by AD.

Discrimination and school outcomes in first nation youth: The role of positive psychological characteristics.

Positive psychological characteristics have been found to be associated with discrimination and school outcomes separately; however, no work has examined these associations together or in North American Indigenous (NAI) populations. NAI adolescents experience high rates of racial discrimination. Because discrimination has a detrimental impact on academic outcomes it is critical to identify factors that could buffer this impact. The purpose of this study was to examine the indirect effect of racial discrimination on three distinct school outcomes (i.e., attitudes toward school, grades, and educational attainment goals) through the pathway of three positive psychological characteristics (i.e., satisfaction with life, subjective happiness, and self-compassion). First Nation adolescents living on a rural reserve in Eastern Canada (N = 106, Mage = 14.6 years, 50.0% female) completed a pencil-and-paper survey in Spring 2017 as part of a larger community-based participatory research study. In the model examining school attitudes, indirect effects through subjective happiness (b = -0.21, 95% confidence interval (CI): [-0.53, -0.03]) and self-compassion (b = -0.19, 95% CI: [-0.39, -0.04]), but not satisfaction with life, were significant. In the model examining grades, only the specific indirect effect through subjective happiness was significant (b = -0.27, 95% CI: [-0.59 -0.07]). Similarly, in the model examining school goals, only the indirect effect through subjective happiness was significant (b = -0.40, 95% CI: [-0.94, -0.08]). The direct effects of discrimination on school attitudes (b = 0.02, 95% CI: [-0.52, 0.56]), grades (b = 0.16, 95% CI: [-0.39, 0.71]), and school goals (b = -0.03, 95% CI: [-0.90, 0.84]) were not significant after controlling for positive psychological characteristics. Schools should foster positive emotions to enhance academic outcomes, especially for NAI youth who are more likely to experience racial discrimination.

Inequity and vulnerability in Latin American Indigenous and non-Indigenous populations with rheumatic diseases: a syndemic approach

Syndemics are a framework that documents health inequities and vulnerabilities in populations with rheumatic diseases. Compared with other approaches, syndemics are able to conjunctly consider epidemiological, biological, sociodemographic and economic...

Deletions in DNAL1 Cause Primary Ciliary Dyskinesia Across North American Indigenous Populations

We report 4 cases of primary ciliary dyskinesia in unrelated indigenous North American children caused by identical, homozygous, likely pathogenic deletions in the DNAL1 gene. These shared DNAL1 deletions among dispersed indigenous populations suggest that primary ciliary dyskinesia accounts for more lung disease with bronchiectasis than previously recognized in indigenous North Americans.

Epidemiology of invasive Haemophilus influenzae disease in northwestern Ontario: comparison of invasive and noninvasive H. influenzae clinical isolates.

In the post-Haemophilus influenzae type b (Hib) vaccine era, invasive H. influenzae type a (Hia) disease emerged in North American Indigenous populations. The role of Hia in noninvasive disease is uncertain; it is unknown whether noninvasive Hia infections are prevalent in populations with a high incidence of invasive disease, and whether invasive and noninvasive Hia isolates have different characteristics. We analyzed all invasive and noninvasive clinical H. influenzae isolates collected in a northwestern Ontario hospital serving 82% Indigenous population over 5.5 years. Serotyping, clonal analysis, and antimicrobial sensitivity testing were conducted on 233 noninvasive and 20 invasive isolates. Among noninvasive isolates, 91% were nontypeable (NTHi) and 3% were Hia; Hia was the most frequent invasive isolate (60%). Incidence rates of invasive H. influenzae disease (12.5/100 000/year) greatly exceeded average provincial data, with the highest found in<6-year-old children (63.9/100 000/year); the proportion of Hia among invasive isolates was seven times larger than in Ontario. No difference in clonal characteristics between invasive and noninvasive Hia isolates was found. Antibiotic resistance was more common among NTHi than among encapsulated isolates, without differences between invasive and noninvasive isolates. Considering the significance of Hia in Indigenous populations, pediatric immunization against Hia will be useful to prevent serious infections in young Indigenous children.

Disparities in rheumatoid arthritis outcomes for North American Indigenous populations

ABSTRACT Advances in rheumatoid arthritis (RA) management have significantly improved clinical outcomes of this disease; however, some Indigenous North Americans (INA) with RA have not achieved the high rates of treatment success observed in other populations. We review factors contributing to poor long-term outcomes for INA with RA. We conducted a narrative review of studies evaluating RA in INA supplemented with regional administrative health and clinical cohort data on clinical outcomes and health care utilisation. We discuss factors related to conducting research in INA populations including studies of RA prevention. NA with RA have a high burden of genetic and environmental predisposing risk factors that may impact disease phenotype, delayed or limited access to rheumatology care and advanced therapy. These factors may contribute to the observed increased rates of persistent synovitis, premature end-stage joint damage and mortality. Novel models of care delivery that are culturally sensitive and address challenges associated with providing speciality care to patients residing in remote communities with limited accessibility are needed. Progress in establishing respectful research partnerships with INA communities has created a foundation for ongoing initiatives to address care gaps including those aimed at RA prevention. This review highlights some of the challenges of diagnosing, treating, and ultimately perhaps preventing, RA in INA populations.

Design and evaluation of a mobile-based intervention for Maya adults during the COVID-19 pandemic

Introduction: The COVID-19 pandemic has had a direct impact on mental health. International organisations have emphasised the vulnerability of indigenous people. Digital Mental Health approaches deliver online therapy as an evidence-based, effective, and accessible treatment option for common mental health problems. However, the evidence regarding these approaches is limited in indigenous populations. The objective of this study is to describe the design, development, and evaluation of the efficacy of a self-applied online intervention regarding the psychological symptoms of depression, anxiety, and fear of COVID-19 in a sample of the Maya population. Method: A prospective longitudinal quantitative study was designed, where a single group was measured before and after receiving the online intervention. This study took place from April to September 2021 and consisted of six sessions delivered via WhatsApp in Spanish and Mayan. Results: The initial assessment was implemented with 82 participants who were evaluated using the Patient Health Questionnaire, Scale for Generalised Anxiety Disorder and the Fear of COVID-19 Scale; 18 participants remained in the intervention for the post-assessment. Statistical differences were observed in PRE and POST measures of depression and anxiety, but not in fear of COVID-19. Conclusions: This study produced positive results for the first online mental health intervention implemented in the Latin American indigenous population. Future studies might consider developing similar interventions for other indigenous communities in Latin America.

Collection of genetic data in ethnic‐based studies across Aymaras, Quechuas and Mestizos: the challenges of the Genetics of Alzheimer’s in Peruvian Population (GAPP) study

AbstractBackgroundThe Genetics of Alzheimer’s Disease in Peruvian Population (GAPP) study aims to investigate genetic and environmental risk factors for Alzheimer’s Disease (AD) in Peru. The project is led by Columbia University (CU, New York, US) and the Instituto Peruano de Neurociencias (IPN, Lima, Peru). For the past year and a half, despite the ongoing COVID‐19 pandemic, the study has collected data on cognitive function, health, diet and numerous clinical and biological risk factors for AD. In addition, we collected blood samples for DNA extraction as well as serum and plasma to look at core AD biomarkers.MethodRecruitment prioritized populations from south Peru, the Quechuas and Aymaras, because of their high proportion of Native American ancestry (or, in other words, low admixture with European ancestry) as well as Mestizo (mixed Native‐European ancestry). Three recruitment sites were established in Lima, Puno and Arequipa. Interviewers were trained to clinically and cognitively assessed the participants and collect and ship blood samples to the main site (IPN). DNA samples were then sent to CU for processing. Serum and plasma samples were processed in Lima and stored at ‐80C for batch shipping to CU. DNA samples were sent to CD Genomics and Children’s Hospital of Philadelphia for APOE genotyping and GWAS, respectively.ResultA database with 350 participants has been created. Blood samples from all participants were collected; 268 successfully underwent GWAS and APOE genotyping. An additional 82 samples are pending QC and genotyping. No samples were dropped at extraction, and only 0.7% failed DNA quality standards for genotyping.ConclusionSample collections for genetic studies in South American indigenous populations such as Peru represent important logistic challenges. The use of blood as a main source of DNA provides an effective and reliable source for genetic data analysis. Plasma and serum biomarkers will provide additional insights into the disease manifestations and validation of the clinical diagnosis in these underrepresented populations. Ongoing recruitment will augment the analytical power of the cohort by collecting blood, serum and plasma samples from additional GAPP participants.

Mozilla in P’urhépecha: translators’ agency in a software translation project

In an effort to preserve and encourage the use of endangered languages, the last decade has witnessed the emergence of transnational projects funded by technology and software development companies such as Google and the Mozilla Foundation. Launched in 2012 by the Mozilla Foundation, the project ‘Native Mozilla’ is aimed at creating a more inclusive digital environment by developing web browsers and applications that will facilitate internet access and use to Latin American indigenous populations. A group of community users, translators, language teachers, developers, activists and other organizations have been particularly active in the translation of Firefox and Firefox Focus, Mozilla’s browsers for PC and Android, in 50 indigenous languages from Argentina, Bolivia, Chile, Colombia, Ecuador, Guatemala, Mexico, Paraguay, and El Salvador. P’urhépecha is the main indigenous language of the state of Michoacán, Mexico. Spoken by nearly 120 000 speakers is considered as a threatened language. This article focuses on the translation project of Firefox Focus to P’urhépecha that took place from November 2014 to November 2018, and that involved the participation of P’urhépecha language and culture teachers, and students and alumni of the BA in Intercultural Language and Communication. In addition to describing the merits and shortcomings of the project, we will examine the translation and the training process. We will be arguing that the limited literacy in P’urphépecha shaped the role played by the working languages, thus influencing their translation choices and strategies.

Naturally acquired antibodies against 7 Streptococcus pneumoniae serotypes in Indigenous and non-Indigenous adults.

Despite the use of pneumococcal conjugate vaccines for pediatric immunization, North American Indigenous populations continue to experience high burden of pneumococcal infections. Naturally acquired antibodies, which can protect unvaccinated adults against pneumococcal infections, have not previously been studied in Canadian Indigenous people. We analysed concentrations of natural serum IgG, IgM and IgA antibodies specific to 7 serotype-specific capsular polysaccharides (3, 6B, 9V, 14, 19A, 19F and 23F) in 141 healthy individuals (age between 18 and 80 years), including Indigenous adults living in 2 geographical different areas of Ontario, Canada, and non-Indigenous residing in northwestern Ontario. Regardless of the geographical area, concentrations of IgG specific to serotypes 6B, 9V, and 14, IgM specific to 9V, and all serotype-specific IgA were significantly higher in Indigenous study participants as compared to non-Indigenous. The differences are likely attributed to an increased exposure of Indigenous individuals to Streptococcus pneumoniae and/or cross-reactive antigens of other microorganisms or plants present in the environment. Although in non-Indigenous adults concentrations of IgM specific to 9V, 19A, 19F, and 23F significantly decreased with age, this was not observed in Indigenous individuals suggesting that Indigenous people may experience continuous exposure to pneumococci and cross-reactive antigens over the life span. Women had generally higher concentrations of natural IgG and IgM concentrations than men, with more striking differences found in Indigenous adults, potentially associated with larger exposure of women to young children, the major reservoir of pneumococci in communities. Our data suggest that increased rates of pneumococcal infections among Indigenous people are unlikely related to deficiency of naturally acquired antibodies, at least those specific to 7 common serotypes. Determining serological correlates of protection for adults will be essential to identify the groups in need of adult pneumococcal immunizations that may prevent excessive burden of the disease among North American Indigenous people.

A genomic perspective on South American human history

It has generally been accepted that the current indigenous peoples of the Americas are derived from ancestors from northeastern Asia. The latter were believed to have spread into the American continent by the end of the Last Glacial Maximum. In this sense, a joint and in-depth study of the earliest settlement of East Asia and the Americas is required to elucidate these events accurately. The first Americans underwent an adaptation process to the Americas’ vast environmental diversity, mediated by biological and cultural evolution and niche construction, resulting in enormous cultural diversity, a wealth of domesticated species, and extensive landscape modifications. Afterward, in the Late Holocene, the advent of intensive agricultural food production systems, sedentism, and climate change significantly reshaped genetic and cultural diversity across the continent, particularly in the Andes and Amazonia. Furthermore, starting around the end of the 15th century, European colonization resulted in massive extermination of indigenous peoples and extensive admixture. Thus, the present review aims to create a comprehensive picture of the main events involved in the formation of contemporary South American indigenous populations and the dynamics responsible for shaping their genetic diversity by integrating current genetic data with evidence from archeology, linguistics and other disciplines.

The genomic landscape of Mexican Indigenous populations brings insights into the peopling of the Americas

The genetic makeup of Indigenous populations inhabiting Mexico has been strongly influenced by geography and demographic history. Here, we perform a genome-wide analysis of 716 newly genotyped individuals from 60 of the 68 recognized ethnic groups in Mexico. We show that the genetic structure of these populations is strongly influenced by geography, and our demographic reconstructions suggest a decline in the population size of all tested populations in the last 15–30 generations. We find evidence that Aridoamerican and Mesoamerican populations diverged roughly 4–9.9 ka, around the time when sedentary farming started in Mesoamerica. Comparisons with ancient genomes indicate that the Upward Sun River 1 (USR1) individual is an outgroup to Mexican/South American Indigenous populations, whereas Anzick-1 was more closely related to Mesoamerican/South American populations than to those from Aridoamerica, showing an even more complex history of divergence than recognized so far.

Association of EDARV370A with breast density and metabolic syndrome in Latinos.

The ectodysplasin receptor (EDAR) is a tumor necrosis factor receptor (TNF) superfamily member. A substitution in an exon of EDAR at position 370 (EDARV370A) creates a gain of function mutant present at high frequencies in Asian and Indigenous American populations but absent in others. Its frequency is intermediate in populations of Mexican ancestry. EDAR regulates the development of ectodermal tissues, including mammary ducts. Obesity and type 2 diabetes mellitus are prevalent in people with Indigenous and Latino ancestry. Latino patients also have altered prevalence and presentation of breast cancer. It is unknown whether EDARV370A might connect these phenomena. The goals of this study were to determine 1) whether EDARV370A is associated with metabolic phenotypes and 2) if there is altered breast anatomy in women carrying EDARV370A. Participants were from two Latino cohorts, the Arizona Insulin Resistance (AIR) registry and Sangre por Salud (SPS) biobank. The frequency of EDARV370A was 47% in the Latino cohorts. In the AIR registry, carriers of EDARV370A (GG homozygous) had significantly (p < 0.05) higher plasma triglycerides, VLDL, ALT, 2-hour post-challenge glucose, and a higher prevalence of prediabetes/diabetes. In a subset of the AIR registry, serum levels of ectodysplasin A2 (EDA-A2) also were associated with HbA1c and prediabetes (p < 0.05). For the SPS biobank, participants that were carriers of EDARV370A had lower breast density and higher HbA1c (both p < 0.05). The significant associations with measures of glycemia remained when the cohorts were combined. We conclude that EDARV370A is associated with characteristics of the metabolic syndrome and breast density in Latinos.

Holy Corn. Interdisciplinary Study of a Mexican 16th-Century Polychrome Maize Stem, Paper, and Colorín Wood Sculpture

Maize stem sculptures, produced during the 16th and 17th centuries in New Spain (today, Mexico) are a clear example of the convergence of the artistic traditions from the American indigenous populations and European influence. This typology of sculptures is not limited to the Americas, as the examples found in European countries have shown. Therefore, a detailed technological investigation is required to correctly classify them. This work presents the interdisciplinary and multianalytical investigation of a 16th-century sculpture made with a maize stem preserved in Guadalajara city, Mexico. We used a set of techniques, such as CT, SEM-EDX, μ-FTIR, and μ-Raman, to study, from a macro to a micro level, the structure, the polychromy, and the modification of the sculpture. The results showed the use of maize stems, paper, and wood in the construction of the sculpture and the use of the traditional polychromy, as well as the numerous modifications that changed its appearance considerably resulting in its misclassification. We were able to associate the statue with the Cortés workshop (Mexico City region), probably produced in the decade of 1580, and track its liturgical use and historical development through the centuries.

A Framework for the Adaptation of Positive Psychological Interventions to North American Indigenous Populations.

Positive psychology research has led to the development of brief interventions designed to promote positive emotions: positive psychological interventions (PPIs). Randomized controlled trials examining PPIs have found them to be effective in increasing well-being and decreasing depressive symptoms. PPIs have been studied in samples consisting primarily of White Americans; however, PPIs may be useful for members of North American Indigenous groups. PPIs align well with Indigenous views on health, which tend to be strengths-based, holistic, and encompassing the whole body (including the medicine wheel's four dimensions of spirit, mind, heart, and body). This paper provides a framework for the adaptation of PPIs for Indigenous communities and a review of preliminary data on the relationships between positive psychological characteristics and health outcomes including substance use. Implications include the potential widespread impact of culturally adapted PPIs given their alignment with Indigenous thoughts on health and relative ease of administration.

A systematic review and meta-analysis of the prevalence of human papillomavirus infection in Indigenous populations - A Global Picture.

Recent trends have shown a decline in the rates of human papillomavirus (HPV)-associated cervical cancer in the vaccinated population but there has been a spike in the HPV-associated oropharyngeal, anal and penile cancers in the majority of the unvaccinated population which are young and middle-aged males. Indigenous populations at an international level carry a disproportionate burden of most diseases. The aim of this meta-analysis was to ascertain the worldwide prevalence of HPV infection in Indigenous populations stratified by sex and site and to document the most commonly reported HPV types. Published articles on HPV infection in Indigenous populations from PubMed, Scopus, EMBASE and Web of Science were systematically searched from inception until 23 December 2019. A total of 41studies were included in the final analysis. The pooled worldwide prevalence of HPV infection (for both oral and genital sites, both males and females) in Indigenous populations was 34.2% (95% CI: 28.9%-39.8%). Subgroup analysis (geographical) showed that the pooled prevalence for African Indigenous, American Indigenous and Asian-Oceanic Indigenous populations were 33.0% (95% CI: 12.8%-57.1%), 33.0% (95% CI: 27.4%-38.9%) and 33.3% (95% CI: 0.17.5%-51.3%), respectively. There are not enough data on the burden of the infection carried by males especially with respect to highly suspicious sites like oropharynx. Also, we conclude an overall high prevalence of HPV infection in the Indigenous populations and increasing their susceptibility to benign and malignant manifestations of HPV.

Low prevalence of anemia among Shuar communities of Amazonian Ecuador.

Anemia is an important global health challenge. We investigate anemia prevalence among Indigenous Shuar of Ecuador to expand our understanding of population-level variation, and to test hypotheses about how anemia variation is related to age, sex, and market integration. Hemoglobin levels were measured in a total sample of 1650 Shuar participants (ages 6months to 86 years) from 46 communities between 2008 and 2017 to compare anemia prevalence across regions characterized by different levels of market integration. Shuar anemia rates among children under 15 years (12.2%), adult women (10.5%), and adult men (5.3%) were less than half of those previously documented in other neo-tropical Indigenous populations. Anemia prevalence did not vary between more traditional and market integrated communities (OR=0.47, p=.52). However, anemia was negatively associated with body mass index (OR=0.47, p=.002). Compared to other South American Indigenous populations, anemia prevalence is relatively low among Shuar of Ecuador and invariant with market integration. Understanding this pattern can provide valuable insights into anemia prevention among at-risk populations.

Frequency of antigen Dia on the blood donor population of the Hemocenter coordinator of the Hemopa Foundation

IntroductionErythrocyte phenotyping is a very important test in the adoption of prophylactic measures to reduce transfusion reactions/alloimmunizations in polytransfused patients. The blood group Diego, in its current, form has 22 antigens, of which 4 are immunogenic, being Diª/Dib and Wra/Wrb, while the others are less expressive. The antigen Diª is of low incidence among whites and blacks, however, it is common in the South American indigenous and Asian Mongolian populations. It is also considered a system of clinical importance for its immunogenicity. MethodThe present study aimed to carry out a retrospective and descriptive survey of the frequency of the Diª antigen in the blood donor population at the HEMOPA Foundation Coordinating Blood Center from 12/2018 to 1/2000. The data obtained were from the HEMOPA Foundation SBS Progress and SBS WEB Systems databases. ResultsDuring this period, 941,744 blood bags were collected and, of these, 930 bags were phenotyped for the Diª antigen, of which 842 were negative and 88 (9.7%) positive. The research showed that, among the positive donors for the antigen Diª, 88.6% were brown, 3.4%, black and 8%, white. In the statistical analysis, the frequency observed was higher in browns. ConclusionIn the present investigation, we concluded that our region has a relatively higher frequency of the Diª antigen, when compared to the rest of Brazil, and it occurs more often in browns.