Healthcare access, attitudes and behaviours among Navajo adults during the COVID-19 pandemic: a cross-sectional study.

OBJECTIVE

To assess factors associated with positive COVID-19 tests, perspectives on health-related care delivery during pandemic, and factors supporting resilience among members of the Navajo Nation.

METHODS AND ANALYSIS

From May through October 2021, a multi-institutional team recruited participants (n=154) to complete a 49-item questionnaire or participate in focus group (n=14) about their experience with COVID-19 and the effects on their use and access to allopathic and traditional health care. A multi-investigator, phenomenological approach summarized focus group experiences.

RESULTS

While 72% had been tested for COVID-19, only 27.5% reported a positive test. Positive tests were not associated with household size or multigenerational homes, though time to grocery store was (p=0.04). There were no significant differences in allopathic or traditional medical care experiences from before and during the pandemic. Despite limited internet access, 28.8% chose a telehealth appointment and 42% expressed satisfaction with their experience. Discussion themes revealed perceived disruptions of healthcare needs with acknowledgement that healthcare providers were supportive throughout the Navajo Nation quarantine.

CONCLUSION

Presence of co-morbidities and living in multigenerational homes do not explain the disproportionate effects of COVID-19 among American Indian communities. Strengthening family and community bonds supported resilience in these communities.