The report reveals that the Native American health care system created by the federal government has used only limited and incremental responses to the health care challenges faced by Native Americans.

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

In this book, the authors highlight the importance of eliminating health disparities and increasing the access of Native Americans to critical substance abuse and mental health services. While most chapters are framed in scientific terms, they are concerned with promoting healing through changes in the way we treat our sick-spiritually, traditionally, ceremonially, and scientifically-whether in rural areas, on reservations, and in cities. The book will be a valuable resource for medical and mental health professionals, medical anthropologists, and the Native health community. Visit our website for sample chapters!

This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews.

The second edition of the Impact Evaluation in Practice handbook is a comprehensive and accessible introduction to impact evaluation for policy makers and development practitioners. First published in 2011, it has been used widely across the development and academic communities. The book incorporates real-world examples to present practical guidelines for designing and implementing impact evaluations. Readers will gain an understanding of impact evaluations and the best ways to use them to design evidence-based policies and programs. The updated version covers the newest techniques for evaluating programs and includes state-of-the-art implementation advice, as well as an expanded set of examples and case studies that draw on recent development challenges. It also includes new material on research ethics and partnerships to conduct impact evaluation. The handbook is divided into four sections: Part One discusses what to evaluate and why; Part Two presents the main impact evaluation methods; Part Three addresses how to manage impact evaluations; Part Four reviews impact evaluation sampling and data collection. Case studies illustrate different applications of impact evaluations. The book links to complementary instructional material available online, including an applied case as well as questions and answers. The updated second edition will be a valuable resource for the international development community, universities, and policy makers looking to build better evidence around what works in development.

Interpersonal trauma is ubiquitous and its impact on health has long been understood. Recently, however, the critical importance of this issue has been magnified in the public eye. A burgeoning literature has demonstrated the impact of traumatic experiences on mental and physical health, and many potential interventions have been proposed. This volume serves as a detailed, practical guide to trauma-informed care. Chapters provide guidance to both healthcare providers and organizations on strategies for adopting, implementing and sustaining principles of trauma-informed care. The first section maps out the scope of the problem and defines specific types of interpersonal trauma. The authors then turn to discussion of adaptations to care for special populations, including sexual and gender minority persons, immigrants, male survivors and Veterans as these groups often require more nuanced approaches. Caring for trauma-exposed patients can place a strain on clinicians, and approaches for fostering resilience and promoting wellness among staff are presented next. Finally, the book covers concrete trauma-informed clinical strategies in adult and pediatric primary care, and women’s health/maternity care settings. Using a case-based approach, the expert authors provide real-world front line examples of the impact trauma-informed clinical approaches have on patients’ quality of life, sense of comfort, and trust. Case examples are discussed along with evidence based approaches that demonstrate improved health outcomes. Written by experts in the field, Trauma-Informed Healthcare Approaches is the definitive resource for improving quality care for patients who have experienced trauma.