Improving Native American Elder Access to and Use of Healthcare

This five-year project was developed by investigators from the Behavioral Health Research
Center of the Southwest (BHRCS), a center of the Pacific Institute of Research and Evaluation
(PIRE), the Health Committee of the New Mexico Indian Council on Aging (NMICoA), and the
University of New Mexico (UNM). The project combines qualitative and quantitative interviews
with concept-mapping (CM) techniques and focus groups to study insurance coverage,
help-seeking behavior, and the healthcare experiences of American Indian Elders (AIEs) in New
Mexico (NM). Practical knowledge grounded in the actual perspectives of AIEs and other key
stakeholders may improve healthcare practices and policies for a population largely excluded
from national and state discussions of health reform. The study data will also inform the
adaptation and development of culturally tailored programming to enrich understanding and
facilitate negotiation of a changing landscape of healthcare by AIEs. Our four specific aims
are to:

1. Assess how AIEs understand, access, maintain, and use insurance coverage.

2. Characterize AIE help-seeking and healthcare experiences in dominant service delivery
settings, i.e., Indian Health Service (IHS), tribally-run 638 facilities, and managed
care programs.

3. Identify and compare factors that affect AIE access to health care as perceived by
multiple stakeholders, i.e., AIEs, outreach workers (OWs), healthcare staff and
providers, public sector administrators, and tribal leaders.

4. Develop and assess implementation feasibility of a structured intervention for OWs that
promotes enhanced patient navigation, in addition to healthcare literacy, access, and
usage among AIEs.

Navigators

Inclusion Criteria:

- Working in a health and health insurance outreach

- Routinely interacting with AIEs as part of their jobs

- Primary service region includes target AIEs.

Exclusion Criteria:

- Not Routinely interacting with AIEs as part of their jobs

- Not willing to be trained in or use the Seasons of Care app

American Indian Elders (AIEs) Inclusion

- Age 55+

- Identifying as AI

- Able to read in English

- Able to consent and complete study procedures

- Interacted with Navigator

Exclusion ● Individuals who cannot read in English or who have not interacted with a pilot
test Navigator will not be eligible to participate

Healthcare Staff/providers Inclusion

- Individuals who have been in contact with a pilot test Navigator

- Work in a healthcare facility that serves AIEs in one of our 4 regions

Exclusion

● Individuals who have not interacted with a pilot test Navigator or do not work in a
healthcare facility serving our primary population, will not be eligible to participate