NURS FPX 6026 Assessment 3 Letter to the Editor Population Health Policy Advocacy

NURS FPX 6026 Assessment 3 Letter to the Editor Population Health Policy Advocacy

Letter to the Editor: Population Health Policy Advocacy

June 21st, 2023

Mr. Moon, Andrew M. MD

Division of Gastroenterology and Hepatology, 

University of North Carolina School of Medicine, 

Chapel Hill, North Carolina, USA

This letter has been written to draw attention to the inadequate care and deleterious outcomes experienced by Native American communities who suffer from alcohol addiction. It calls for policy changes that consider these individuals’ medical conditions and social context, providing evidence-based and patient-centered care to improve the health of both mother and child. The purpose is to spark awareness with the hope of inspiring aid for this population facing discrimination, stigma, and a lack of access to proper treatment.

The publication, Addictive Behaviors, reveals research and discussion focusing on addiction-related topics such as the prevention, treatment, epidemiology, and policy surrounding substance use disorders. Composed of peer-reviewed articles and reviews alike, this journal recently published an article “Systematic Review of addiction recovery mutual support groups and Indigenous People of Australia, New Zealand, Canada, the United States of America, and Hawaii” (Dale et al., 2019). In its rigorous editorial process, it assures that all papers are subject to evaluation to guarantee high-quality content (Dale et al., 2019).

This research by Dale et al. (2019) investigated the impact of addiction recovery mutual support groups on Indigenous people in five countries, namely Australia, New Zealand, Canada, the United States of America, and Hawaii. Through a systematic review of existing literature in this area, the authors concluded that culturally sensitive and community-led strategies may lead to successful outcomes among Native Americans with alcohol addiction. This article thus contributes further knowledge toward effective approaches for treating addictions within these populations (Dale et al., 2019).

Evaluation of the Current State of the Quality of Care

The care and outcomes for alcohol addiction in Native American individuals is a crucial issue that requires immediate consideration concerning several factors. It is important to consider the cultural, historical, and social elements that have shaped how this population views alcohol use and affects their vulnerability to addiction (Asnaani et al., 2022). While there are gaps in understanding, we know that Native Americans suffer from higher rates of alcoholism than other ethnic or racial groups in America leading to serious health issues such as increased mortality due to alcoholism, liver ailments, and mental health disorders. Therefore, it is essential to understand the current prevalence of alcohol abuse among Native Americans and its impact on their communities when assessing the quality of care given and the resulting consequences (Asnaani et al., 2022).

Alcohol addiction affects many Native American communities, but it can be difficult to access quality treatment due to isolation, inadequate healthcare systems, and inequitable funding (Solomon et al., 2022). To ensure successful outcomes, we must assess the success rate of current treatments for alcohol dependency in Indigenous communities and evaluate the availability of evidence-based approaches and culturally sensitive treatments. Combining conventional therapies such as behavioral therapies and medication with traditional healing methods tailored specifically for Native Americans may help boost recovery rates. By examining this combination, we can gain valuable insight into the effectiveness of available treatment options (Solomon et al., 2022).

Knowledge Gaps

Despite the advances in alcohol addiction treatment for Indigenous communities, there are still areas of need (Morojele et al., 2021). Improved data collection processes, tools to evaluate intervention effectiveness and longer-term research are required to increase knowledge on this topic among Native Americans. Gaining insight into the cultural backdrop is essential for a successful course of treatment. Research should be conducted to understand how experiences with historical trauma, familial impacts, ethnic background, and community resilience influence alcohol abuse and recovery efforts amongst Native Americans. Additionally, research should be done to evaluate if customized interventions utilizing traditional healing methods have positive long-term results in treating alcohol addiction among these individuals (Morojele et al., 2021).

Analysis of Health Policy Development

The quality of care and outcomes for alcohol addiction in Native Americans is unsatisfactory, which points to the necessity for health policy reform and advocacy activity. This group has distinct problems that necessitate exclusive policies and campaigns to deal with disparities and enrich care (Nunnally et al., 2021). Native Americans suffer from higher rates of alcohol addiction than other groups, thus making it essential for health strategies to acknowledge this situation by dedicating ample resources, money, and specialized programs toward prevention, treatment, and recovery efforts directed at them (Nunnally et al., 2021).

Native American societies have particular cultural values, convictions, and healing practices that should be taken into account when creating health policies. Health policymakers should develop protocols to guarantee treatment programs honor traditional healing, language use, and community participation (Cohen‐Fournier et al., 2021). They should also strive to ensure healthcare professionals are mindful of these traditions by establishing rules and expectations for culturally appropriate behavior. To improve access to care for alcohol addiction among Native Americans, policymakers can focus on providing more healthcare centers in impoverished areas; increasing the number of specialized addiction treatment options around the country; as well as making telehealth services available where geographical obstacles make it difficult to receive support locally. Organizing advocacy efforts to fight for changes in existing policies that center on the needs of indigenous peoples is equally essential for eradicating disparities in healthcare provision (Cohen‐Fournier et al., 2021).

Areas of Ambiguities

It is important to examine the efficacy of various interventions for addressing alcohol addiction among Native Americans (Blue Bird Jernigan et al., 2018). Investigating how well-tailored programs, traditional treatments, and peer support work in practice can help practitioners better understand which policies are most likely to yield positive results. Results must be tracked closely and changes should be made if it appears that the protocols are not yielding desired outcomes. This will offer the best chance at providing quality care for individuals struggling with alcohol abuse while also achieving successful long-term behavioral change (Blue Bird Jernigan et al., 2018).

Developed Policy is Vital for the Quality of Care

Creating a policy is critical for improving the quality of care and results in Native American populations with alcohol addiction. Formulating policy encourages equitable access to treatment and care, and lessens disparities such as geographical restrictions, scarcity of resources, and lack of cultural understanding while promoting fairness and equal opportunities for those looking for help (Leston et al., 2019). Policies are designed to ensure that Native American communities have access to the resources and funding they need to address alcohol addiction. These policies focus on preventing, treating, recovering from, and providing support for this particular issue based on its unique characteristics and historical context. They promote evidence-based practices so that quality care is provided with a higher chance of positive results, rather than relying solely on resource gaps (Leston et al., 2019).

Creating a policy necessitates bringing different persons holding a stake, such as healthcare practitioners, community organizers, lobbying organizations, and individuals and families of Native American descent dealing with alcohol addiction (Chater & Loewenstein, 2022). This cooperative strategy promises that multiple perspectives are heard before the completion of policies that take into account the varied needs and objectives of the targeted group. Including people with a vested interest in this process reinforces the initiative by providing support, creating responsibility for those involved, and supporting the successful execution of programs. Policies serve as guidelines to ensure continual betterment in care results related to addiction to alcohol. By establishing standards and regulations, there is an open outline for planning efficiently while constantly keeping track of progress and evaluating outcomes – thus ensuring success in successfully managing this problem (Chater & Loewenstein, 2022).

Other Perspectives

Different people may have contrasting views on the purpose of policy-making related to alcohol addiction. Some may focus more heavily on personal agency, encouraging individuals to take charge and seek treatment without relying too much on created rules. Others might prioritize incorporating traditional approaches favored by Native American communities that are culturally sensitive. Proponents of local and community-based solutions may contend that grassroots efforts, collaborations with the local population, and localized initiatives produce more substantial results when addressing alcohol addiction compared to protocols developed at higher levels. Nevertheless, a holistic approach is paramount for success. To guarantee equal access to science-backed care and paraphernalia, policy development should take into account cultural sensitivity, individual liberty, and community participation (Chater & Loewenstein, 2022).

Advocate for Policy Development in Other Care Settings.

The development of policies is essential to address the issue of alcohol addiction among Native Americans, both in the healthcare system and in other care settings. Advocacy for policy implementation in educational systems can promote prevention and early intervention initiatives by integrating alcohol education into curricula, thus providing students with awareness, risk reduction strategies, and information on where to obtain help (Chavula et al., 2022). This approach can be effective for tackling alcohol-related issues at an early stage and allow Native American youth to make informed decisions. Advocacy for rules in educational frameworks can be a fundamental part of prevention and early intervention initiatives. Establishing guidelines can help make sure alcohol education is incorporated into school curriculums to enhance comprehension, risk reduction plans, and the value of seeking assistance. This could address problems right away and give Native American youth the information and resources needed to make informed choices (Chavula et al., 2022).

Native American tribes have the power to create and carry out strategies within their countries. Encouraging policymaking at the tribal level can lead to rules and plans that facilitate alcohol addiction prevention, therapy, and healing initiatives (van Schalkwyk et al., 2022). These policies can help set up a combined system among tribal governments, healthcare providers, and community organizations to address issues with alcohol use. Advocating for policies that offer more support and alternatives to incarceration for people dealing with alcohol addiction within the criminal justice system may help reduce recidivism rates among Native Americans. Such strategies could include diverting people into programs or treatments rather than jail, as well as offering specialized services within the legal system (van Schalkwyk et al., 2022). 

Potential Challenges

To create effective policies to tackle alcohol addiction in Native American populations, policymakers, healthcare professionals, and community leaders must work together to address the cultural sensitivities of these communities (Blue Bird Jernigan et al., 2018). Constructive collaboration is needed for trust between parties to be established and Cultural barriers must be overcome so that policies are relevant and sensitive. Advocates must work within the confines of limited resources to make a convincing case for why funding should be allocated to address substance use disorder in Indigenous populations. A successful outcome requires collaboration between various stakeholders, including government officials, healthcare providers, communities, and advocates; however, getting all parties to agree on the same objectives can be difficult. To achieve consensus relationships must be built with mutual respect and understanding, open discussions take place regarding conflicting opinions, and views are heard by each representative involved (Blue Bird Jernigan et al., 2018).

Interprofessional Aspects

A successful policy to manage alcohol addiction in Indigenous populations could be improved by using an interdisciplinary and integrated team approach (Pijl et al., 2022). This would involve multiple healthcare professionals coming together to evaluate the needs, strengths, and problems connected with this issue. Professionals specializing in addiction medicine, psychology, social work, and nursing, and those with cultural knowledge of the people could contribute their expertise to create a tailored intervention strategy that takes into account each individual’s unique situation. Interprofessional collaboration is key to assessing the needs, strengths, and difficulties related to alcohol addiction among Native American people. Through the input of professionals from a range of areas such as medicine, psychology, social work, and nursing, and those with cultural expertise, it is possible to gain a comprehensive understanding of the community’s requirements and create appropriate interventions accordingly (Pijl et al., 2022).

Alcohol addiction necessitates an all-encompassing approach including healthcare professionals and supportive services. Interdisciplinary collaboration facilitates the provision of synchronized care to ensure that the various facets of treatment and assistance are working together harmoniously. This can involve incorporating medical, psychological, communal, and cultural approaches to attend to the multifaceted requirements of Native Americans with alcohol dependency. Interprofessional collaboration can support the growth of healthcare professionals by furnishing them with opportunities for capacity building, knowledge sharing, and professional development. By establishing educational programs, workshops, and shared learning initiatives that bring together different disciplines, Native American populations can benefit from improved care quality and evidence-based practices. Such collaboration reinforces a culture of marketing ongoing improvement in healthcare delivery (Pijl et al., 2022).

Areas of Ambiguities

Collaboration between healthcare professionals can be beneficial when it comes to addressing alcohol addiction in Native American populations. However, there is a need for more guidance and clarity on the roles and responsibilities of various disciplines to ensure effective service delivery. Further research and information could help identify any potential overlaps or gaps. Improving cultural understanding among healthcare providers is vital to providing quality care. To properly address the particularities of Native American cultures regarding addiction and recovery, further research is necessary on which tactics are most successful for cultural competence training. This involves gaining insight into the social subtleties, historical background, and tribe-specific procedures connected to alcohol recovery (Pijl et al., 2022).

I am pleased to have the opportunity to offer my ideas and perspectives on this significant issue. I would be grateful to get an update regarding your thoughts, and I am willing to give any extra information or specifications as needed.



Asnaani, A., Sanchez-Birkhead, A., Kaur, K., Mukundente, V., Napia, E., Tavake-Pasi, F., Villalta, J., Lee, D., Stark, L., Brown, H., & Crowell, S. (2022). Utilizing community partnerships to devise a framework for cultural adaptations to evidence-based mental health practice in diverse communities. Cognitive and Behavioral Practice29(4), 831–845.

Blue Bird Jernigan, V., D’Amico, E. J., Duran, B., & Buchwald, D. (2018). Multilevel and community-level interventions with native Americans: Challenges and opportunities. Prevention Science21(S1), 65–73.

Chater, N., & Loewenstein, G. (2022). The I-frame and the S-frame: How focusing on individual-level solutions has led behavioral public policy astray. Behavioral and Brain Sciences, 1–60.

Chavula, M. P., Zulu, J. M., & Hurtig, A.-K. (2022). Factors influencing the integration of comprehensive sexuality education into educational systems in low- and middle-income countries: a systematic review. Reproductive Health19(1).

Cohen‐Fournier, S. M., Brass, G., & Kirmayer, L. J. (2021). Decolonizing health care: Challenges of cultural and epistemic pluralism in medical decision‐making with Indigenous communities. Bioethics35(8), 767–778.

Dale, E., Kelly, P. J., Lee, K. S. K., Conigrave, J. H., Ivers, R., & Clapham, K. (2019). Systematic review of addiction recovery mutual support groups and Indigenous people of Australia, New Zealand, Canada, the United States of America and Hawaii. Addictive Behaviors98, 106038.

Leston, J., Crisp, C., Lee, C., & Rink, E. (2019). An interview project with native American people: a community-based study to identify actionable steps to reduce health disparities. Public Health176, 82–91.

Morojele, N. K., Dumbili, E. W., Obot, I. S., & Parry, C. D. H. (2021). Alcohol consumption, harms and policy developments in sub‐Saharan Africa: The case for stronger national and regional responses. Drug and Alcohol Review40(3), 402–419.

Nunnally, M. E., Ferrer, R., Martin, G. S., Martin-Loeches, I., Machado, F. R., De Backer, D., Coopersmith, C. M., Deutschman, C. S., Antonelli, M., Hellman, J., Jog, S., Kesecioglu, J., Lat, I., & Levy, M. M. (2021). The surviving sepsis campaign: Research priorities for the administration, epidemiology, scoring and identification of sepsis. Intensive Care Medicine Experimental9(1).

Pijl, E. M., Alraja, A., Duff, E., Cooke, C., Dash, S., Nayak, N., Lamoureux, J., Poulin, G., Knight, E., & Fry, B. (2022). Barriers and facilitators to opioid agonist therapy in rural and remote communities in Canada: An integrative review. Substance Abuse Treatment, Prevention, and Policy17(1).

Solomon, T. G. A., Starks, R. R. B., Attakai, A., Molina, F., Cordova-Marks, F., Kahn-John, M., Antone, C. L., Flores, M., & Garcia, F. (2022). The generational impact of racism on health: Voices from American Indian communities. Health Affairs41(2), 281–288.

van Schalkwyk, M. C. I., Petticrew, M., Maani, N., Hawkins, B., Bonell, C., Katikireddi, S. V., & Knai, C. (2022). Distilling the curriculum: An analysis of alcohol industry-funded school-based youth education programmes. PLOS ONE17(1), e0259560.

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