Miller McCall, Vaughn Lisa M, Benashley LeCario, Bones Billie, Buonfiglio Samantha, Lee-Gatewood Gwendena, Paxson Amanda, Sarnacki Rachel, Walker Rhiannon, Whitesinger Dawnafe, Beaton Andrea, de Loizaga Sarah
Heart Institute, Cincinnati Children's Hospital Medical Center Cincinnati OH USA.
Division of Emergency Medicine Cincinnati Children's Hospital Medical Center Cincinnati OH USA.
J Am Heart Assoc. 2025 May 20;14(10):e036624. doi: 10.1161/JAHA.124.036624. Epub 2025 May 7.
Cardiac disease is a leading cause of death in American Indian populations, and echocardiographic screening within 1 tribal nation revealed 6% of tribal members had undiagnosed structural heart disease (SHD). However, improved strategies for scale-up of screening and wrap-around care are needed to improve outcomes. The purpose of this study was to engage tribal members in identifying priorities related to heart health to inform scalable models for improved SHD diagnosis, care, and outcomes.
We used group-level assessment, a qualitative and participatory large group method, to collaboratively generate information and interactively evaluate themes with relevant community members. Together with a Community Research Leadership Board established for this project, we held 4 group-level assessment sessions throughout the tribal land. Themes from each session were combined and distilled into priority areas. A total of 163 tribal members participated in the group-level assessment sessions. Five priorities for an SHD program were identified: (1) heart health/SHD education and awareness; (2) cultural considerations; (3) inclusive, multigenerational community engagement; (4) improved resources for general health and wellness; and (5) accessible, patient-centered health care with local cardiac care.
Group level assessment was the first step in our efforts to improve outcomes for American Indian tribal members with SHD. The generated community insights will directly inform the development of a cardiac disease extender program that will be codesigned with members of the Community Research Leadership Board, tribal community health workers, and the larger community.
心脏病是美国印第安人群的主要死因，在一个部落国家内进行的超声心动图筛查显示，6%的部落成员患有未被诊断出的结构性心脏病（SHD）。然而，需要改进扩大筛查和全方位护理的策略以改善治疗效果。本研究的目的是让部落成员参与确定与心脏健康相关的优先事项，以为改善结构性心脏病的诊断、护理和治疗效果的可扩展模式提供信息。
我们使用群体层面评估，这是一种定性且参与性的大型群体方法，与相关社区成员合作生成信息并交互式评估主题。我们与为此项目设立的社区研究领导委员会一起，在整个部落土地上举行了4次群体层面评估会议。每次会议的主题被合并并提炼为优先领域。共有163名部落成员参加了群体层面评估会议。确定了结构性心脏病项目的五个优先事项：（1）心脏健康/结构性心脏病教育与认知；（2）文化考量；（3）包容的、多代人的社区参与；（4）改善总体健康和 Wellness 的资源；（5）可及的、以患者为中心的医疗保健及当地心脏护理。
群体层面评估是我们努力改善患有结构性心脏病的美国印第安部落成员治疗效果的第一步。所产生的社区见解将直接为心脏病扩展项目的开发提供信息，该项目将与社区研究领导委员会成员、部落社区卫生工作者及更广泛的社区共同设计。
