American Indian Behavioral Health Treatment Preferences as Perceived by Urban Indian Health Program Providers

Behavioral health services specifically targeted for ethnoracial clients are typically tailored to the specific needs and preferences of these populations; however, little research has been done with American Indian clients specifically. To better understand how clinicians handle provision of treatment to this population, we interviewed 28 behavioral health staff at six Urban Indian Health Programs in the United States and conducted focus groups with 23 staff at five such programs. Thematic analysis of transcripts from these interviews and focus groups suggests that these staff attempt to blend and tailor empirically supported treatments with American Indian cultural values and practices where possible. Simultaneously, staff try to honor the client’s specific preferences and needs and to encourage clients to seek cultural practices and connection outside of the therapy room. In so doing staff members were acutely aware of the limitations of the evidence base and the lack of research with American Indian clients.

Diabetes Prevention and Care Capacity at Urban Indian Health Organizations

American Indian and Alaska Native (AI/AN) people suffer a disproportionate burden of diabetes and cardiovascular disease. Urban Indian Health Organizations (UIHOs) are an important source of diabetes services for urban AI/AN people. Two evidence-based interventions—diabetes prevention (DP) and healthy heart (HH)–have been implemented and evaluated primarily in rural, reservation settings. This work examines the capacity, challenges and strengths of UIHOs in implementing diabetes programs.Methods: We applied an original survey, supplemented with publicly-available data, to assess eight organizational capacity domains, strengths and challenges of UIHOs with respect to diabetes prevention and care. We summarized and compared (Fisher's and Kruskal-Wallis exact tests) items in each organizational capacity domain for DP and HH implementers vs. non-implementers and conducted a thematic analysis of strengths and challenges.Results: Of the 33 UIHOs providing services in 2017, individuals from 30 sites (91% of UIHOs) replied to the survey. Eight UIHOs (27%) had participated in either DP (n = 6) or HH (n = 2). Implementers reported having more staff than non-implementers (117.0 vs. 53.5; p = 0.02). Implementers had larger budgets, ~$10 million of total revenue compared to $2.5 million for non-implementers (p = 0.01). UIHO strengths included: physical infrastructure, dedicated leadership and staff, and community relationships. Areas to strengthen included: staff training and retention, ensuring sufficient and consistent funding, and data infrastructure.Conclusions: Strengthening UIHOs across organizational capacity domains will be important for implementing evidence-based diabetes interventions, increasing their uptake, and sustaining these interventions for AI/AN people living in urban areas of the U.S.

"IT LOOKS BETTER ON INSTAGRAM": NETWORKED PHOTOGRAPHY AND PUBLIC ART IN MUMBAI

In this paper, I discuss networked photography practices and selfie cultures at the Kala Ghoda Arts Festival, an annual cultural festival in Mumbai, to demonstrate how global digital visual cultures are translated in the urban Indian context, and offer new ways of thinking about the conceptualisation and experience of art, the city and the resident. I argue that the desire for networked photography that animates the assemblage of installations, artists, visitors, curators, camera technologies and social networking sites, alters ideas of space and place, and object production and meaning making. I approach the selfie and everyday networked photography as a form of self-expression, labour (Abidin 2016), locative media (Hess 2015), embodied socialisation (Frosh 2015) and a mode of photography that collapses binaries of subject/object, spectator/operator and curated image/curator (Frosh 2015, Senft and Baym 2015). I use qualitative digital methods, interviews, audiovisual documentation and autoethnography. Through visuals recorded in the exhibition area at the Kala Ghoda Arts Festival in 2020, I demonstrate how the unique sense of intimacy and limited field of vision offered by the lens and screen of the camera phone, turn the exhibition space into a space of embodied interdependence and collaboration. At the same time, as a result of the neoliberal logic of commodification of the algorithms of social networking sites, postcolonial place is rendered ahistorical and reinterpreted as a space for creative photography and the visual production of a global digital identity.