Urban Indian Academic Knowledge Map 2007

The  Urban Indian Academic Knowledge Map 2007, was NCUIH's first project aimed at discovering both what academic research on Urban Indian communities had been conducted in the past 20 years, and how that related to our health status. The  lack of  available information and knowledge prompted NCUIH to embark itself  in a quest to  find, locate, categorize and share all knowledge about our communities with our leaders and invested parties. As such, the Knowledge Map became the first step towards creating the Knowledge Resource Center. Since this  is an ongoing quest, NCUIH  keeps  collecting  Urban Indian-specific information  to make it available to our members. We are in the process of finalizing the information collected in 2008 and 2009. This document shall be available in fall 2010


Summary

I.Background

II. What exactly is knowledge mapping?

III. Why a knowledge map?

IV. Graphics from findings

V. Research methods

VI. Data abstraction

VII.Data management and data analysis

VIII. Training, quality assurance, and confidentiality

IX. Research findings


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I.BACKGROUND

Approximately 2,624,000 Americans who reside in urban areas identify themselves as Native Americans alone or in combination with another race (2000 U.S. Census). This urban Indian population belongs to the poorest population segments in the country and endures critical health conditions, e.g. presenting the highest rates of health disparities in the nation (the U.S. Census Bureau in August 2006). These conditions are correlated with shorter life-spans and higher propensities to contract or develop diseases (The Health and Poverty Correlation Studies by the Urban Indian Health Institute). In the US, urban Indians suffer from chronic conditions at rates much higher than the general population, such as diabetes (54% higher), chronic liver disease/cirrhosis (126% higher), alcoholism (176% higher), HIV/AIDS (3rd highest infection rate), among others.

II. WHAT EXACTLY IS KNOWLEDGE MAPPING?

It's an ongoing quest within an organization  to help discover the location, ownership, value and use of  knowledge items to learn the roles and expertise of people, to identify constraints to the flow of knowledge, and to highlight opportunities to leverage existing knowledge *1.


III. WHY A KNOWLEDGE MAP?

Little is known about the Urban Indian Population. Funds have never been enough to appropriately document the challenges . In order to better/properly address the healthcare needs of the urban Indian population from a policy oriented perspective, it is necessary to identify the status of health in the community. This can be done either by carrying out actual health study programs of the population or by accessing and interpreting published scientific studies and research papers, which is the purpose of the Knowledge Map. Thus by gaining an understanding of the knowledge available as well as the gaps in our knowledge there can be a renewed focus on the actual research needed to further identify and address the healthcare needs of the population. 


IV. GRAPHICS FROM FINDINGS

All Investigators Type of institution with the largest/Lowest number of submissions

Type of Organization


NCUIH Region reporting the largest/lowest number (or Percentage) of Principal Investigators 

Geographic Locations


Research Design Type Distribution/Frequency of the academic research database documents ( in percentage)

Research Design


Research Setting Type Distribution/Frequency of the academic research database documents (in percentage)

Research Setting


Sample by age frequency in the academic research database documents (in percentage)

Sample by Age


V. RESEARCH METHODS

To gather the sample, a search using the key words: Urban + Indian + American + Health was performed on 25 June 2006, using the US online library of medicinewww.pubmed.com. A total of 290 articles were returned and analyzed. Of these studies, 138 were deemed eligible for use, as they

-          included information on urban American Indians living in the U.S.
-          were published between 1986 and 2006,
-          and were available for viewing. 


VI. DATA ABSTRACTION

Three reviewers abstracted data on the following study characteristics:

v  Articles title
v  Year of publication
v  Principal Investigators name, Principal Investigators Institutions, Type of Institution, US Region where the Institution is located, Contact Information, Principal Investigators Address.
v  Other authors Name, Institutions, Type of Institution.
v  Key words
v  Health Topics
v  Design (qualitative or quantitative)
v  Settings
v  Region where the research was conducted
v  Sample characteristics
v  Focus of the research (patient, provider, program)
v  Small abstract In article
v  Long Abstract
v  Funding
v  Journal where the article was published 

VII. DATA MANAGEMENT AND DATA ANALYSIS

Two researchers analyzed the data. Each reviewer independently entered the information in the database. Data was summarized with descriptive statistics. The following general data analysis plan was performed by using SPSS 12.0 for Windows. First, data was examined for frequencies and distributions. Second, variables were considered as continuous or categorical depending on distributions. Third, univariate analyses and stratified analyses were also explored.


VIII. TRAINING, QUALITY ASSURANCE, AND CONFIDENTIALITY

The NCUIH team received training prior to the data management and analysis portion of the work to ensure standard implementation of the study procedures.  The research staff also met weekly to review procedures and to ensure the completeness of the data collection. Additionally, the principal investigator and NCUIHs Directors met weekly to discuss the status of the research. All data entry was checked for completeness and the database flagged missing data and out of range values. All data was entered on password protected computers. All data was saved in two computers and kept on a backup disk to assure that the data was not lost. 


IX. RESEARCH FINDINGS

NCUIH works in twelve regions (Bemidji, Nashville, Portland, California, Albuquerque. Phoenix, Alaska, Oklahoma, Aberdeen, Billings, Tucson, and Navajo), ten of which submitted articles for the study.  The majority of the institutions, which the principal investigators belonged to, were geographically located in the Bemidji, Nashville, Portland and California regions. There were no principal investigators institutions located in the Navajo and Tucson regions (see graphic 1).

The Bemidji region, including clinics in Minneapolis, Detroit, Chicago, and Milwaukee, submitted the most information twenty-six studies concerning urban Indian health.  The Nashville region, which has three clinics, came in a close second with twenty-five studies. While the California and Portland regions had twenty-four each.  Then the graph drops steeply with only seventeen submissions from the Albuquerque area and eleven from the three Phoenix clinics.  It drops even further for the Alaska and Aberdeen regions, which only have three submissions each. Similarly, the findings for the Oklahoma and Billings regions are low with two submissions each, thus providing very little information for these last four particular regions. The Navajo Area clinic in Flagstaff Arizona and the clinic in Tucson each had zero submissions providing us insufficient information for those areas.

Of the 137 primary investigators institutions, 58% came from the top four regions: Bemidji, Nashville, California, and Portland. 

While these four regions are well represented in our sample, the coverage is still too slim to diagnose the endemic healthcare problems of the urban Indian community.  The scarce research of the other eight areas provides us with even less information on the health issues of those areas, and should be prioritized in further studies.

Note 1: The NCUIH Academic Knowledge Map 2007, was NCUIH's first step towards creating  the Knowledge Resource Center!

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