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Cultural Specificity and Comparison in Psychiatric Epidemiology: Walking the Tightrope in American Indian Research
Abstract
Increasingly, the mental health needs of populations are measured using large-sample surveys with standardized measures and methods. Such efforts, however, rarely include sufficient number of smaller, culturally defined populations to draw defensible conclusions about their needs. Furthermore, without some adaptation, the standardized methods and measures may yield invalid results in such populations. Using a recently completed psychiatric epidemiology and services study with American Indian populations as a case example, this paper outlines issues facing epidemiologists working in such culturally diverse contexts. The issues discussed include the following: (1) persuading the scientific community and potential sponsors that work with distinct or culturally defined populations is important; (2) framing research questions and activities to meet the needs of communities; (3) defining a population of inference; (4) balancing the needs for comparability and cultural specificity; (5) maximizing scientific validity in light of the challenges in sample acquisition; and (6) developing and implementing data collection methods that uphold scientific standards but are also realistic given the context. The authors draw on their experiences--most recently in the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP)--to illustrate these issues and suggest ways to address each. A goal of this paper is to challenge those invested in conducting culturally valid epidemiologic work in such populations to better articulate the nature of these efforts.
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Training so-called lay interviewers or data collectors is time-consuming and complex, especially as attrition is common due to family responsibilities, community politics, or inadequate financial compensation.
“and, relatedly, the time-consuming complexity of training so-called “lay interviewers” or data collectors, especially as attrition is common due to family responsibilities, community politics, or inadequate financial compensation.”
From Addressing the need for indigenous and decolonized quantitative research methods in Canada (2021) · cites this paper as Beals et al., 2003
Due to the scarcity of existing Indigenous epidemiologists/health information specialists, most Indigenous organizations are required to hire non-Indigenous epidemiologists/health information specialists who lack an understanding of Indigenous worldviews, knowledge, and language systems, put in requests for data and/or data analysis through non-Indigenous organizations, or hire and train community
“Due to the scarcity of existing Indigenous epidemiologists/health information specialists, most Indigenous organizations are required to hire non-Indigenous epidemiologists/health information specialists who lack an understanding of Indigenous worldviews, knowledge, and language systems, put in requests for data and/or data analysis through non-Indigenous organizations, such as the Institute of”
From Addressing the need for indigenous and decolonized quantitative research methods in Canada (2021) · cites this paper as Beals et al., 2003
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Self-citationSawchuk, C. N., Roy‐Byrne, P., Goldberg, J. H., Manson, S. M., Noonan, C., Beals, J., & Buchwald, D. (2005) · Psychological Medicine · doi:10.1017/s0033291705005751 · Cited by 67
Self-citationDevelopmental Trajectories of Personal and Collective Self-Concept Among American Indian Adolescents
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Spirituality and mental health status among Northern Plain tribes
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Self-citationStress Burden and Diabetes in Two American Indian Reservation Communities
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Self-citationTraumatic events and alcohol use disorders among American Indian adolescents and young adults
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Self-citationAmerican Indian Youth: Personal, Familial, and Environmental Strengths
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Self-citationMarijuana Initiation in 2 American Indian Reservation Communities: Comparison With a National Sample
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Self-citationThe AI-SUPERPFP Team, Beals, J., Belcourt-Dittloff, A., Garroutte, E. M., Croy, C. D., Jervis, L. L., Whitesell, N. R., Mitchell, C. M., & Manson, S. M. (2012) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-012-0615-5 · Cited by 56
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Historical Consciousness Among Two American Indian Tribes
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Self-citationLifetime Prevalence of Posttraumatic Stress Disorder in Two American Indian Reservation Populations
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Self-citationPike, I. L., & Patil, C. L. (2006) · Culture Medicine and Psychiatry · doi:10.1007/s11013-006-9022-2 · Cited by 49
Gone, J. P. (2023) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-080921-072950 · Cited by 53
The basic research factors questionnaire for studying early childhood caries
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Childhood abuse and later parenting outcomes in two American Indian tribes
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Deters, P. B., Novins, D. K., Fickenscher, A., & Beals, J. (2006) · American Journal of Orthopsychiatry · doi:10.1037/0002-9432.76.3.335 · Cited by 42
Self-citationRelationship Between Post-traumatic Stress Disorder and Pain in Two American Indian Tribes
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Self-citationAmerican Indian Youth Substance Abuse: Community‐Driven Interventions
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Self-citation
Metadata
- Authors
- Beals, J., Manson, S. M., Mitchell, C. M., Spicer, P., & AI-SUPERPFP Team
- Affiliations
- University of Colorado Health (US)
- ORCID
- Manson, Spero M.
- Venue
- Culture Medicine and Psychiatry
- Published
- 2003-09
- Volume
- 27
- Issue
- 3
- Pages
- 259-289
- ISSN
- 0165-005X (ISSN-L)
- 1573-076X
- OpenAlex
- W2066055158
- Cited by
- 182
- References
- 64
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 8 · 2020: 3 · 2019: 5 · 2018: 10 · 2017: 12 · 2016: 5 · 2015: 7 · 2014: 5 · 2013: 13 · 2012: 11
- FWCI
- 13.20
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Culture Medicine and Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA013420, R01 AA-13420)
- National Institute of Mental Health (P01MH042473, P01-MH-42473, R01-MH48174, R01MH048174)
- National Institute on Drug Abuse (R01DA014817, R01-DA-14817)
- Topics
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Cultural Competency in Health Care
- Keywords
- American Indian populations, cultural specificity, cultural validity, psychiatric epidemiology, mental health services research, comparability, sample acquisition, community needs
- MeSH terms
- Mental Disorders, Cross-Cultural Comparison, Humans, Indians, North American, Research Support as Topic, Risk Factors, United States, Prevalence, Diagnosis, Dual (Psychiatry), Cultural Diversity, Substance-Related Disorders, Needs Assessment
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