Purpose: Oral health disparities related to access persist for American Indian/Alaska Native (AI/AN) communities compared to the general population, especially in rural areas of the United States. The objective of this study was to better understand community perspectives of oral health, how rurality impacts access to care, and attitudes towards the implementation of dental therapists in Oklahoma, particularly among the AI/AN population. Methods: A descriptive, observational study design was utilized. An exploratory survey was conducted online and comprised of qualitative and quantitative data. The total frequencies and percentages were evaluated for the quantitative questions. The qualitative data was analyzed using thematic analysis. Utilizing descriptive and qualitative research methods, the focus was to describe the experiences of the respondents and their characteristics related to oral health in Oklahoma. Results: A total of 201 responses were obtained, where 65% (n = 131) identified as an enrolled member or employee of a tribe represented in Oklahoma. Key qualitative themes included community access to care, community concerns, and community motivated solutions. Conclusions: AI/AN communities are an underserved group in healthcare. Although communities in rural areas face major barriers to oral health services, evidence-based solutions can be implemented.

Little is known about the environmental health-related policies and practices of early care and education (ECE) programs that contribute to childhood asthma, particularly in Oklahoma where child asthma rates (9.8%) and rates of uncontrolled asthma among children with asthma (60.0%) surpass national rates (8.1% and 50.3%, respectively). We conducted a cross-sectional survey with directors of Oklahoma-licensed ECE programs to assess policies and practices related to asthma control and to evaluate potential differences between Centers and Family Childcare Homes (FCCHs). Surveyed ECEs (n = 476) included Centers (56.7%), FCCHs (40.6%), and other program types (2.7%). Almost half (47.2%) of directors reported never receiving any asthma training. More Center directors were asthma-trained than FCCH directors (61.0% versus 42.0%, p < 0.0001). Most ECEs used asthma triggers, including bleach (88.5%) and air fresheners (73.6%). Centers were more likely to use bleach daily than were FCCHs (75.6% versus 66.8%, p = 0.04). FCCHs used air fresheners more than did Centers (79.0% versus 61.0%, p < 0.0001). The majority of ECEs (74.8%) used pesticides indoors. Centers applied indoor pesticides more frequently (i.e., monthly or more often) than did FCCHs (86.0% versus 58.0%, p < 0.0001). Policy, educational, and technical assistance interventions are needed to reduce asthma triggers and improve asthma control in Oklahoma ECEs.

American Indians, Alaska Natives, and Native Hawaiians (AI/AN/NH) have among the lowest representation in clinical trial participation in the United States (US) compared with other racial/ethnic groups and experience many barriers to health care access. To promote equitable and justice-centered inclusion of Indigenous Peoples in clinical trials and improve health equity, industry sponsors need to be better attuned to community-based priorities. This article summarizes perspectives including strategies to build more effective and equitable partnerships with Indigenous communities in the US and to advance access to medical care. A panel of advisors on AI/AN/NH health care assembled for a virtual roundtable discussion in March 2024. A narrative review, supported by key publications, was conducted to summarize and contextualize the discussions. AI/AN/NH face various health inequities and challenges in clinical trial enrollment, including justified distrust of medical research environments, inaccessible and unaffordable health care, and limited community engagement by the research community. Proposed methods for engagement based on advisor insights were developed to guide industry sponsors in building more effective partnerships with Indigenous communities. Engagement methods consist of several strategies such as investing in community priorities, building a long-term commitment, identifying trusted messengers, and co-developing engagement initiatives. Current challenges regarding clinical trial diversity are impacting health outcomes among Indigenous Peoples, furthering disparities. Based on advisor engagement, establishing effective, equitable, and justice-centered partnerships between industry sponsors and Indigenous Peoples has the potential to result in community-driven priorities being recognized in clinical trials, and thus expanding benefit of medical innovation.