Year of Award

2025

Document Type

Professional Paper

Degree Type

Master of Arts (MA)

Degree Name

Communication Studies

Department or School/College

Department of Communication Studies

Committee Chair

Heather Voorhees

Commitee Members

Christina G. Yoshimura, Kimber McKay

Keywords

Indigenous Health, Type 2 Diabetes, Blackfeet, Amskapi Pikuni, Browning Montana, Blackfeet Health

Subject Categories

Health Communication

Abstract

This study explores how culturally appropriate communication influences perceived quality of care and communication satisfaction among patients with T2D. Grounded in the Culture-Centered Approach (Dutta, 2008), this study explores how cultural identity, systemic structures, and communication practices shape the ways that Amskapi Pikuni individuals navigate their care, and seeks to ask: How, if at all, does a provider’s culturally competent communication influence a Blackfeet patient’s management of their T2 Diabetes? This project is based on in-depth, qualitative interviews with 13 Blackfeet participants, most living within the exterior boundaries of the Blackfeet reservation and receiving their primary healthcare at the local Indian Health Service (IHS) hospital. Interviews focused on narratives, relational dialogue, and shared meaning-making between the participants and researcher. Data collection and analysis was grounded in Indigenous Research Methods (IRMs), from Kovach (2021), Absolon (2022), and Wilson (2008), and situational analysis/situational mapping (Clarke, 2018) and was committed to honoring the lived experiences and traditional Niitsitapi ways of knowing. As an Amskapi Pikuni researcher I approached the data with cultural and relational accountability, guided by Niitsitapi teachings and responsibilities to my community. Three bundles emerged--Resilience, Identity, and Systems of Care--which represent more than thematic categories, reflecting the realities of navigating healthcare as an Amskapi Pikuni person with T2D, where cultural values, systemic barriers, and individual agency intersect in complex and nuanced ways. Throughout this project, I remained committed to following IRMs by listening with intention and approaching each narrative with humility, understanding, and as a transfer of knowledge between the participants and myself. I view this research as a living body of knowledge--a collective Mopistaan-- meant to be shared, cared for, and returned to my community. Based on my data collection and analysis, I recommend the following actions for improving healthcare communications to improve health outcomes for Blackfeet patients with T2D: 1. Implement a dedicated cultural liaison within the local healthcare setting to ensure culturally-grounded communication, advocacy, and support throughout the entirety of the care process. 2. Establish a provider training rooted in Amskapi Pikuni communication and care protocols, that are focused on Blackfeet-specific practices and values, including sopoya’payoohtsimi (to listen carefully), relational accountability, and culturallycentered approaches to health and wellness. 3. Prioritize the continuity of care models that support long-term patient-provider relationships, that allow the Blackfeet community members to build overall trust with incoming providers. These findings, along with an infographic poster (Appendix 7), will be shared back with my community and given to the Blackfeet Nation IRB, as well as Blackfeet Tribal Health. The infographic will be shared with other interested Indigenous focused healthcare facilities, such as All Nations Health Center in Missoula, and other interested tribal health facilities or UIOs. This project underscores the need for healthcare systems, especially those serving Indigenous communities, to provide care in ways that honor Indigenous knowledge systems, lived experiences, and respect the right for Indigenous patients to be heard, seen, and cared for. Ultimately, the findings of this project show that culturally responsive communication and respectful care are not just preferential, but necessary for Indigenous health equity.

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© Copyright 2025 Zita K. Ottersbach