Improving Native American Elder Access to and Use of Healthcare Through Effective Health System Navigation

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.