Social scientists routinely employ sociodemographic variables such as race, ethnicity, and sex as independent variables in their research. These "social address" variables typically stand in, either explicitly or implicitly, for the more explanatory variables believed to underlie them. For instance, race and ethnicity often serve merely as proxies for the values, beliefs, and behaviors (i.e. culture) that are assumed to correlate with them. "Unpacking" proxy variables--directly measuring the variables believed to underlie them--can provide a more reliable and more interpretable way of looking at group differences in patterns of illness, service use, and outcomes. The present study examines the factors hypothesized to underlie ethnicity as it relates to adaptation to, and outcomes of, managing type II diabetes in a veteran population. Two instruments were developed to measure seven domains believed to correlate with ethnicity: economic marginality, domestic and family workload, domestic help, family relations, saliency of religion, proactive response to illness, and negative impact of illness. It was hypothesized that these domains would have an impact on the relationship with health care provider, severity of illness, utilization of urgent health care services, and quality of life. Twelve Anglo veterans and 16 Hispanic veterans with type II diabetes were interviewed using the semi-structured Ecocultural Veteran Interview (EVI). These veterans, and an additional 17 Anglo veterans and 10 Hispanic veterans, also received a self-report instrument modeled after the EVI, the Ecocultural Veteran Self-Report (EVSR). Multitrait-Multimethod analyses were used to compare the reliability and validity of the two instruments. Sequential hierarchical general linear models were used to assess the utility of the measures in accounting for variance in the outcome measures. Results indicate that the EVSR taps into the same domains as the more resource-intensive EVI. Furthermore, the domains are correlated with self-reported ethnic identification. These domains directly predict the relationship with provider, utilization of urgent health care services and quality of life. In addition, the domains interact with patient characteristics to predict severity of illness. The evidence from this study suggests that research focusing on improving the measurement of ecocultural variables in health services research is likely to be fruitful.

This purpose of this dissertation is to investigate how four Mexican American male adolescents perceive their literacy within and outside of school. Particular attention is given to the literacies found in the family, gang, school, and juvenile court communities. Initially, the four Mexican American male adolescents who participated in this study were students in my alternative classroom. Later, I officially advocated for them and their families in the educational system. I worked with each participant for four years. Each participant is a member of a gang and has struggled with being successful in school. The ethnographic case study design of the research, enabled me to examine each participant's literacy story. Data collection methods included in-depth interviews, participant observation and field notes, and the gathering of written and visual artifacts such as school assignments, personal journals, individual tags, personally written raps, and photographs. Data were organized into "case study data bases" and each participant's story contributed to a larger discussion of the individual communities in which the four members participated. The research revealed that all four participants come from rich literacy environments and that the social and political roles of literacy varied within the different communities. These multiple roles controlled the participants' use of literacies to navigate within the educational and juvenile court systems.

The daughter of a Mohawk chief and an English immigrant, Pauline Johnson had an unusual childhood which exposed her to Shakespeare and Byron, as well as to her Mohawk grandfather's ancient stories. Her writing reflected her parents' optimism and belief that her dual heritage was the beginning of a new world in which native values and abilities would be integrated as important contributions to Canadian society as a whole. For nearly seventeen years Johnson toured Canada, the United States, and England, reciting her own poetry and adding her own humorous observations. Aware that her special draw to her audiences was her native heritage, Johnson assumed the stage persona of "The Mohawk Princess," and wore a buckskin dress, moccasins, a bearclaw necklace, and other accouterments as she recited angry poems protesting white treatment of native peoples. In the second half of her performance, however, she changed into an evening gown, thereby subverting her audience's expectation of the stereotyped identity, "Indian." Although her performances succeeded in disrupting, for an evening, the dominant colonial discourse, she was ultimately co-opted as a sentimental trope and today is often dismissed as a serious writer. However, such dismissal overlooks the fact that Pauline Johnson was the first and only native writer to make her living from her writing. During the four years between her retirement from the recital platform and her death in 1913, she produced more than 80 short stories that appeared in national magazines. This dissertation examines examples of the colonial discourse of her contemporaries and Johnson's response to such discourse for clues to her current near-exclusion from the Native American literary canon.

An important question in the area of child development is the nature of the relationship between social and cognitive development. Does cognitive development affect social competence, are there reciprocal effects between the two areas, or does social competence affect cognitive development? The present study investigated the direction of effect between social development and cognitive development in Native American children during early childhood. The study involved the secondary analysis of existing data from the Navajo Nation Transition Project. Data for one hundred and fifty-one children attending Kindergarten were used in the study. The children were graduates of Head Start, a program that offered services to promote the development of low-income children and their families. Cognitive and social developmental level in this study was measured by a measurement and planning system (MAPS) devised for the assessment of young children's developing ability through a path-referenced approach. A nonrecursive linear structural equation model was used to examine if there was a reciprocal relationship between social and cognitive development. The study revealed a direction of effect from cognitive development to social development. No reciprocal relationship was found between the two areas of development. Future research directions and implications were also addressed.

Following the end of World War II and the formation of the United Nations organization, indigenous minorities who had fought on behalf of First World nations--including record numbers of New Zealand Maori and American Indians--pursued their longstanding efforts to assert cultural and political distinctiveness from dominant settler populations with renewed vigor. In the first decades after the War, New Zealand Maori and American Indians worked largely within dominant discourses in their efforts to define viable contemporary indigenous identities. But by the late 1960s and early 1970s, both New Zealand and the United States felt the effects of an emerging indigenous "renaissance," marked by dramatic events of political and cultural activism and by unprecedented literary production. By the mid-1970s, New Zealand Maori and American Indians were part of an emerging international indigenous rights movement, signaled by the formation and first general assembly of the World Council of Indigenous Peoples (WCIP). In "Blood As Narrative/Narrative As Blood," I chronicle these periods of indigenous minority activism and writing and investigate the wide range of tactics developed for asserting indigenous difference in literary and political activist texts produced by the WCIP, New Zealand Maori, and American Indians. Indigenous minority or "Fourth World" writers and activists have mobilized and revalued both indigenous and dominant discourses, including the pictographic discourse of plains Indian "winter counts" in the United States and the ritual discourse of the Maori marae in New Zealand, as well as the discourse of treaties in both. These writers and activists have also created powerful tropes and emblematic figures for contemporary indigenous identity, including "blood memory," the ancient child, and the rebuilding of the ancestral house (whare tipuna). My readings of a wide range of poems, short stories, novels, essays, non-fiction works, representations of cultural and political activism, and works of literary, art history, political science, and cultural criticism lead to the development of critical approaches for reading indigenous minority literary and political activist texts that take into account the complex historical and cultural contexts of their production--local, national and, increasingly, global.

The purpose of this study was to examine the predictive and content validity of the Portraits Questionnaire (PQ), a universal values survey, for use with consumers of state-federal rehabilitation services. Convenience samples of Native American and Non-Native American consumers receiving services from Arizona Rehabilitation Services Administration were selected to represent the range of value priorities found in the diverse national population of rehabilitation consumers. A test for predictive validity was established by proposing a null hypothesis that the responses to the PQ by the study groups would not predict group membership. An examination of content validity was based on the logical relationship between the responses to the PQ by the two study groups and the values attributed to the two study groups in the literature. Two null hypotheses were established to test content validity. The first null hypothesis predicted that the Native American group would not assign a higher priority to PQ value types, Benevolence, Tradition, Conformity, and Security, than the Non-Native American group would. The second null hypothesis predicted that the Non-Native American group would not assign a higher priority to value types, Self-Direction, Stimulation, Hedonism, Achievement, Power, and Universalism, than the Native American group would. Copies of the PQ were mailed to 259 Native American and 263 Non-Native American consumers. Usable responses were received from 96 members of the Native American group and 97 members of the Non-Native American group. Discriminant Analysis of the data produced a significant discriminant function (Wilks' Lambda = .856, p = .001) that predicted correct group membership for 65.8% of the cases. The null hypothesis was rejected and predictive validity of the Portraits Questionnaire for the study groups accepted. Univariate analysis of the data revealed two significant (p ≤ .05) discriminant variables, Tradition and Stimulation. The standardized canonical discriminant function coefficients indicated that both variables were predictors of Native American membership. Therefore, both null hypotheses for content validity were retained. Tradition was the only value type that predicted group membership as expected. Interpretations of the results are offered and implications presented. The need for further research is discussed.

Mexican Americans constitute one of the fastest growing populations in the United States. Within Mexican American families, women are the primary caretakers and are responsible for managing family health. Many activities of health work fall within the household and domestic spheres. These activities include, providing a clean, safe environment providing nutritious foods, teaching hygienic practices, diagnosing and treating illnesses, and deciding when to seek outside health care. Until recently, household health work was not recognized as a factor in health knowledge and had been excluded from the discourse of health and healing. The purpose of this study was to describe health perceptions and health production among Mexican American women. This research was a descriptive ethnographic study of the health perceptions and health production of a sample of 13 English speaking Mexican American women. Informants participated in three in-depth interviews conducted over a two to four month period. The Household Production of Health was the conceptual model that guided this research and the World Health Organization definition of health was used to frame questions about health perceptions. Data analysis was directed towards identifying themes and sub-themes that were organized into categories that answered the three research questions. The informants integrated physical and mental health into an overarching concept of being healthy. Health included maintenance of the physical body, the mind, and the spirit. The informants identified a variety of health producing and help-seeking activities that were contextualized throughout their lives and were consistent with their health perceptions. In addition to outside employment, the informants took primary responsibility for health creation. Their roles were predominantly domestic in nature and included parenting, providing for health care, and managing and maintaining the household. This research has significance for nursing in three areas: (a) it explicates the importance of routine activities in health maintenance; (b) it provides a framework for community health nurses to analyze the entirety of health activities that occur within the household; and, (c) it suggests the importance of focusing health education on wellness behaviors such as stress reduction and coping strategies.

The number of elderly Asian immigrants in the United States is steadily increasing. Like all elders, those from Asia need health services; however, little is known about their health care needs or how they maintain health and navigate the health care system in a new land. The purpose of this study was to develop a substantive theory of health and wellness maintenance processes among elderly Thai immigrants based on a synthesis of their verbalized perceptions of (1) health; (2) the impact of the immigration experience on their health and wellness; and (3) strategies they used to manage the migration experience relative to health. Grounded theory, the methodology selected for this study, is a naturalistic and systematic approach to knowledge generation guided by the symbolic interaction perspective. As such, it focuses on the social context and interactional matrix of symbolic meaning and behavior from which basic social processes can be inferred. The results included the core category of "Discovering a Balance", a basic social psychological process that consisted of three phases: Learning the System, Becoming Self-Empowered, and Combining the Two Worlds. "Balance" does not mean only "being stable". Rather, "Balance" is a dynamic and intellectual process, always moving the individual toward the ultimate goal in life. "Discovering a Balance" represents a cyclical and dynamic process that aging immigrants use to gain a balance in their lives by using selective knowledge, skills, and resources from both Eastern and Western perspectives toward health and wellness maintenance. The process can reoccur time after time depending on experiences confronted by aging immigrants. Based on the data in this study, "Balance" can occur if elderly immigrants are surrounded by strong nurturing environments. Understanding Asian elder's complex experiences of immigration and the maintenance of health and wellness as affected by migration, a major life change, is imperative for health care providers to assist them appropriately. Professional caregivers can offer more culturally sensitive clinical interventions to the elderly during and following the transitional migration process. More culturally appropriate health services can be expected to lead to an improved quality of life and decreased cost of health care.

Although Europeans unquestioningly impacted the indigenous economies of the Americas, these original economies have shifted, but have never entirely disappeared. Early European witnesses of these tribal systems were often off the mark in interpreting their observations, especially when the data was forced into completely European models. With the secondary sources available, a less Eurocentric model of the 18th and 19th century Choctaw economy can be constructed. This reconstruction will help develop more accurate portrayals of functions within tribal societies.

The purpose of this study was to discover what modesty means to healthy, middle-aged Mexican-American women living in Tucson, Arizona. Accepted ethnographic methodology was used in this exploratory descriptive study. Three audio-taped interviews of one to two hours in length and field notes were used in data collection. A purposive, convenience sample of three Mexican-American women was used. Modesty emerged as a concept inextricably linked to culture. Women's roles were the domains of meaning through which the themes of protection, respect, servility and conflict were described. Modesty in Mexican-American women and the impact it has on health care situations was discussed. Implications for nursing practice were explored.