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Healing Through Representation: An Integrative Review of American Indian and Alaska Native Students in Health
Kristin Payestewa-Picazo1, Timian M Godfrey1,2, Tim Joseph Sowicz3
1Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ, USA.
Abstract:
Background: The underrepresentation of American Indian and Alaska Native (AI/AN) professionals in health care exacerbates health disparities and limits culturally relevant care. The AI/AN students in health professions face challenges such as financial barriers, cultural isolation, and systemic discrimination. Objective: This review examines the barriers and facilitators influencing the success of AI/AN students in health professions education, identifying strategies for improvement. Methods: A synthesis of 14 peer-reviewed studies examined factors affecting the success of AI/AN students, with a focus on challenges, interventions, and outcomes. Results: Key challenges include academic structures that do not incorporate Indigenous knowledge, a lack of AI/AN faculty and mentors, and the struggle to balance professional training with cultural identity. Interventions such as culturally tailored mentorship, financial support, and retention programs have improved retention and graduation rates. Conclusion: The findings underscore the need for institutional reforms, including the integration of Indigenous perspectives into curricula and the strengthening of partnerships with tribal colleges and universities. While short-term programs offer vital support, addressing systemic issues requires long-term structural change. Future research should focus on longitudinal studies, policy evaluations, and holding institutions accountable for advancing equity in health-care education.
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