TITLE: Traditional Healing Prac &CAM Utilization in the San Carlos Apache Tribe: The San Carlos Apache Tribe (SCAT) in Arizona has over 14,000 members and is in the process of assuming management of healthcare facilities from the Indian Health Service (IMS) under Public Law 93- 638, the Indian Self-Determination and Education Assistance Act of 1975. In addition, the tribe is in the process of planning and designing a new hospital to be built on the reservation in the next 5-10 years. The obesity and diabetes prevention program operated by the tribe is directed by a naturopathic physician, and anecdotal reports from dozens of community members indicate the desire for expansion of complementary and alternative medicine (CAM) in the community. In addition, community leadership would like to offer traditional American Indian healing methods in the new facility. However, the community's preferences for CAM and traditional medicine has not been quantified or qualified. However, healthcare service delivery needs to be done in a culturally appropriate manner in order to be appropriately received and utilized. This project will assist the tribe in developing culturally appropriate health services. The Integrative Medicine Attitudes Questionnare (IMAQ), a validated CAM survey tool, will be modified based on key informant interviews and focus groups in SCAT to be culturally relevant. This process has never been done in an American Indian community and has the potential to lead to further studies and interventions in this underserved population. The research team is unmatched in its experience working with Indian health programs, CAM services and research, and in qualitative methods using community wide surveys. Although numerous studies exist that examine utilization of CAM generally, none have been conducted in an American Indian community. Data from this study will be directly applied to the development of new facilities and services in the San Carlos Apache Tribe.
