Improved Integration of Native American Cultural Practices into the American Healthcare System

The persistent prejudice and ostracization faced by the American Indian and Alaska Natives (AI/AN) community has contributed to a lack of resources, disrupting the political and economic state of the AIAN community (Thornton, 1987; Jones, 2006; Crepelle, 2023). Systematic alienation of the AIAN community in healthcare has resulted in differences in the form of treatment and a lack of trust and connectedness between patient and provider (Jones, 2006, 2020; Crepelle, 2023; Mangla & Agarwal, 2023). In the literature reviewed, there was only a connectedness scale used to grade how the patient felt toward the provider (Mohatt et al., 2011; King et al., 2019; Peters et al., 2019). However, there was no connectedness scale used to evaluate the provider or institutional agency providing healthcare. Using previous literature, a qualitative connectedness questionnaire was adopted with the intention of using a structured interview and questioning approach to determine how Indian Health Services (IHS) agencies promoted connectedness and trust between patients and providers (Mohatt et al., 2011; King et al., 2019; Peters et al., 2019; The Indian Health Services, n.d; (ITUs List - Indian Health Service (IHS), Tribally-Operated 638 Programs, and Urban Indian Health Programs in Arizona, n.d.). From there, a thematic analysis analyzed similarities and differences between agencies finding common themes (Ryan & Bernard, 2003; Swanbrow Becker et al., 2017). One finding indicated a lack of representation amongst the providers even though much of the ‘initial staff’ i.e. receptionists and medical assistants were of AIAN descent. As a result, more representation amongst those in the upper management of healthcare can help to increase a sense of connectedness and trust between patient and provider (Mangla & Agarwal, 2023) . Keywords: AIAN, Connectedness, Trust, Lack of Representation, Healthcare