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Health Care Access and Utilization for American Indian Elders: A Concept-Mapping Study
[Concept mapping of PMTCT implementation challenges and solutions across 6 Sub-Saharan African countries in the NIH-PEPFAR PMTCT implementation science alliance]

Author

Listed:
  • David H Sommerfeld
  • Elise Trott Jaramillo
  • Erik Lujan
  • Emily Haozous
  • Cathleen E Willging
  • Deborah Carr

Abstract

ObjectivesInequities in access to and utilization of health care greatly influence the health and quality of life of American Indian elders (AIEs). This study explores the importance and perceived prevalence of factors affecting health care use within this population and assesses the changeability of these factors to produce a list of action items that are timely and relevant to improving health care access and utilization.MethodConcept mapping was conducted with AIEs (n = 65) and professional stakeholders (n = 50), including tribal leaders, administrators of public-sector health systems, outreach workers, and health care providers. Data were analyzed using multidimensional scaling and cluster analyses.ResultsThe final concept-map model comprised nine thematic clusters related to factors affecting elder health care: Difficulties Obtaining and Using Insurance; Insecurity from Lack of Knowledge; Limited Availability of Services; Scheduling Challenges; Provider Issues and Relationships; Family and Emotional Challenges; Health-Related Self-Efficacy and Knowledge; Accessibility and Transportation Barriers; and Tribal/National Policy.DiscussionFindings suggest that improvements in access to and utilization of health care among AIEs will require actions across multiple domains, including health system navigation services, workforce improvements, and tribal, state, and federal policy. A multilevel socioecological approach is necessary to organize and undertake these actions.

Suggested Citation

  • David H Sommerfeld & Elise Trott Jaramillo & Erik Lujan & Emily Haozous & Cathleen E Willging & Deborah Carr, 2021. "Health Care Access and Utilization for American Indian Elders: A Concept-Mapping Study [Concept mapping of PMTCT implementation challenges and solutions across 6 Sub-Saharan African countries in th," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 76(1), pages 141-151.
    • Handle: RePEc:oup:geronb:v:76:y:2021:i:1:p:141-151.
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    References listed on IDEAS

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    1. Kelly, Cheryl M. & Baker, Elizabeth A. & Brownson, Ross C. & Schootman, Mario, 2007. "Translating research into practice: Using concept mapping to determine locally relevant intervention strategies to increase physical activity," Evaluation and Program Planning, Elsevier, vol. 30(3), pages 282-293, August.
    2. Espey, D.K. & Jim, M.A. & Cobb, N. & Bartholomew, M. & Becker, T. & Haverkamp, D. & Plescia, M., 2014. "Leading causes of death and all-cause mortality in American Indians and Alaska Natives," American Journal of Public Health, American Public Health Association, vol. 104(S3), pages 303-311.
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