Heart failure & cardiomyopathies
Centering Diné (Navajo) Voices: Barriers, Facilitators, and Perceptions of Cardiac Care Among Patients With Heart Failure in Rural Navajo Nation
Authors' conclusion
As the first qualitative study of American Indian patients with heart failure in the current era, these results highlight unique care challenges, which can inform community-designed strategies to improve access to care.
Study context
- Population
- Diné (Navajo) patients with HF receiving care at Indian Health Service (IHS) sites in rural Navajo Nation
- Participants
- 30 participants
- Outcome
- Barriers, facilitators and perceptions of cardiac care, and patient-designed solutions
Methodological detailssemi-structured interviews and surveys, thematic analysis, 2 IHS sites, 27% female, 30% Navajo speaking, median age 59 (IQR 53, 67) years, Interviews guided by the Consolidation Framework for Implementation Research
- Semi-structured interviews and surveys
- Thematic analysis
- 2 IHS sites
- 27% female, 30% Navajo speaking, median age 59 (IQR 53, 67) years
- Interviews guided by the Consolidation Framework for Implementation Research
Main finding
As reported in the abstract
Barriers, facilitators and perceptions of cardiac care
- Barriers: lack of local specialists, transportation and financial barriers to travel to urban centres, complicated IHS referral processes, mistrust of providers outside IHS
- Facilitators: trust of local IHS care; community and family support; patient and caregiver resiliency and activation
- Most patients felt Traditional Medicine important for CV health and desired more integration into Western treatment
- Heterogeneous cultural beliefs on heart transplantation; majority felt it acceptable if needed
- Proposed solutions: more local services, more telehealth, assistance for social determinants of health (healthier food, transportation costs for referral care)
Original publication
Centering Diné (Navajo) Voices: Barriers, Facilitators, and Perceptions of Cardiac Care Among Patients With Heart Failure in Rural Navajo Nation. Circulation. Published 31 March 2025. doi:10.
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