Culture, Traditions, and Consumer Engagement With the Wind River Indian Reservation Health Care System

This project, funded by The Robert Wood Johnson Foundation, was a partnership among Sundance Research Institute, the Wind River Indian Reservation Indian Health Service, and the Eastern Shoshone and Northern Arapaho Tribal Health Departments. The objective of the project was to engage and activate the community and individual Tribal members to participate in and guide changes to IHS and support individual consumers to become active and involved participants in their health care and processes through use of technology, social media, and a Patient Navigator. Involvement of cultural and traditional leaders in collaborating with the IHS and Tribal health systems was a unique aspect of this project. This project focused both on community engagement and individual consumer engagement in the health care system and included implementation and evaluation components. Engagement of American Indian consumers in their health care system and health processes offers a unique opportunity to develop a model of consumer engagement for Indian County that integrates cultural and traditional values of the community into the health system and encourages more effective use of available health resources to improve processes of care and outcomes.
The specific objectives of this project were:

  • Engage the Wind River community actively in the assessment and guidance of quality improvement initiatives.
  • Involve traditional healers and Tribal elders to develop culturally-appropriate supports and linkages to support consumer engagement and activation.
  • Use social media processes to engage the community and individual consumers in managing their health and health care.
  • Establish a patient navigator program to assist consumers.
  • Evaluate the program and its impacts and lessons learned and disseminate findings to other Tribes, IHS programs, and the research community.

The major outcome anticipated was an increase in community and individual consumer engagement with IHS and Tribal Health systems that results in positive improvement in health care access, quality, and patient satisfaction. Tribal Work Groups were actively engaged in identifying key factors for quality improvement that would increase access and patient satisfaction. Indian Health Service and Tribal Health directors worked closely with the working groups to identify priorities and feasible Quality Improvement strategies that were subsequently implemented. Findings can be generalized to IHS facilities throughout Indian Country, as well as to Tribally-run health systems. Institutionalizing community and individual consumer engagement processes will support sustainability, providing consumers with experience in active involvement to improve services and processes of care.