Implementation of a COVID-19 Screening Testing Program in a Rural, Tribal Nation: Experience of the San Carlos Apache Tribe, January–February 2021

The COVID-19 pandemic has disproportionately affected tribal populations, including the San Carlos Apache Tribe. Universal screening testing in a community using rapid antigen tests could allow for near–real-time identification of COVID-19 cases and result in reduced SARS-CoV-2 transmission. Published experiences of such testing strategies in tribal communities are lacking. Accordingly, tribal partners, with support from the Centers for Disease Control and Prevention, implemented a serial testing program using the Abbott BinaxNOW rapid antigen test in 2 tribal casinos and 1 detention center on the San Carlos Apache Indian Reservation for a 4-week pilot period from January to February 2021. Staff members at each setting, and incarcerated adults at the detention center, were tested every 3 or 4 days with BinaxNOW. During the 4-week period, 3834 tests were performed among 716 participants at the sites. Lessons learned from implementing this program included demonstrating (1) the plausibility of screening testing programs in casino and prison settings, (2) the utility of training non–laboratory personnel in rapid testing protocols that allow task shifting and reduce the workload on public health employees and laboratory staff, (3) the importance of building and strengthening partnerships with representatives from the community and public and private sectors, and (4) the need to implement systems that ensure confidentiality of test results and promote compliance among participants. Our experience and the lessons learned demonstrate that a serial rapid antigen testing strategy may be useful in work settings during the COVID-19 pandemic as schools and businesses are open for service.

Going Into a Community, We Need to Start From Where They’re At: Caregiver and Advocate Perspectives

We recorded and inductively coded an open-ended discussion of jargon surrounding “dementia” with the “Supporting Dementia Caregivers After Death” community advisory board (CAB). CAB-members included current and former caregivers of PLWD due to early- and normal-onset Alzheimer’s, Lewy body, and Parkinson’s, a co-president of the Alzheimer’s Association (ALZ) Young Champions, a dementia trainer/consultant and member of a Catholic church that preserves American Indian spiritual traditions, a senior program manager at ALZ who was entrusted by American Indian reservation elders to provide dementia education, a care partner support group leader, and an Alzheimer’s Ambassador chosen by multiple US senators. Themes identified included differential inclusiveness of terms like “memory loss” versus “dementia”, misuse and misunderstanding of “dementia” versus “Alzheimer’s,” and the difficulty of translating “dementia” into the American Indian Ojibwe (i.e., Anishinaabemowin) language where suggested translations directly translated to “slow memory loss”, “brain deterioration”, “absent mindedness”, or even “craziness”.

Tradition, Sovereignty, and Conservation: The Controversy Surrounding the Wind River Indian Reservation Game Code

In December 1983, a highly publicized slaughter of over fifty elk at Wind River Indian Reservation reignited a dispute between the reservation’s resident tribes—the Eastern Shoshone and Northern Arapaho nations—over wildlife management. In response to diminished big game populations, the Eastern Shoshone Tribe had passed hunting regulations in 1980, but the people of the Northern Arapaho Tribe refused to do so, effectively derailing any attempt to manage wildlife at Wind River. After the Bureau of Indian Affairs imposed a game code on the reservation in 1984, the Northern Arapaho Tribe initiated a legal battle that culminated in the 1987 case of Northern Arapahoe Tribe v. Hodel. The court ruled that because the treaty rights of the two tribes overlapped in the area of wildlife management and because research conducted by the U.S. Fish and Wildlife Service at the request of both tribes had revealed a need for hunting regulations, the U.S. government had the power to impose the Wind River Reservation Game Code. Although the tribes jointly manage wildlife today and big game populations now thrive at Wind River, it is important to examine the controversy that involved conflicting visions of and concerns about cultural traditions, tribal sovereignty, and wildlife conservation principles and practices. Exploring how Eastern Shoshones and Northern Arapahos viewed those subjects differently and how their longstanding rivalry at Wind River shaped this conflict highlights some problems with the simplistic and romanticized concept of the “Ecological Indian.”

Suicide Ideation and Depression Quality of Life Ratings in a Reservation-Based Community of Native American Youths and Young Adults

Suicide among adolescents is a significant public health concern in the U.S., especially within American Indian and Alaska Native (AIAN) communities. Lack of quality of life (QoL) estimates for both suicide ideation and depression specific to the AIAN population hinders the ability to compare interventions in cost-effectiveness analysis. We surveyed 200 AI youth and young adults from the Fort Apache Indian Reservation to estimate utility weights for experiencing suicide ideation and depression. Our results indicate that, on a scale of 0–100, with higher scores indicating better health, the general community rates both suicide ideation and depression at 15.8 and 25.1, respectively. These weights are statistically significantly different and lower than for other cultures. Culturally specific QoL values will allow the comparison and identification of the most effective and feasible interventions to reduce the suicide burden among tribal communities.

Identifying Service Gaps Between Patients and Providers in a Native American Outpatient Clinic

Background: Native American communities in Montana reservations have reported low-level satisfaction in health services. This research explored if the services provided at a Blackfeet Indian Reservation outpatient clinic were designed to meet patient expectations. Methods: Staff and patient interviews and surveys allowed service expectations to be assessed according to the clinic’s ability to meet those expectations. A total of 48 patients and ten staff members (83% of the staff at this clinic) participated in the study voluntarily. Results: We found a disconnect between what patients anticipate for care and what staff think they are anticipating. We also found a discontent between what staff believes patients need versus what the patients feel is needed. Conclusions: These gaps combine to increase the breach between patient expectations and perceptions of their healthcare services. With better insight that captures what patients are looking for from a service, the potential to meet those needs increases and patients feel that their voice is respected and that they are valued.

Occurrence of mummy berry associated with huckleberry (Vaccinium membranaceum) caused by Monilinia spp. in Oregon

In this Short Communication we describe the occurrence of mummy berry associated with huckleberry (Vaccinium membranaceum) caused by Monilinia spp. in Oregon. To our knowledge, this is the first report of a Monilinia spp. associated with mummy berry of huckleberry in Oregon. Sequence data from our specimens reveal the closest identity was Monilinia vaccinii-corymbosi, a pathogen of commercial blueberry (Vaccinium corymbosum). This may be a new species of Monilinia, not previously reported on huckleberry, and further investigation is needed. Of specific importance, the huckleberry holds cultural importance as a sacred First Food of the Confederated Tribes of the Umatilla Indian Reservation (CTUIR) and other Pacific Northwest tribes. While plant pathogen management in natural landscapes presents unique challenges, we will work with tribal authorities to understand if cultural management techniques may mitigate yield loss due to Monilinia spp.