The integration of primary care and mental health care is a requirement of the Patient Protection and Affordable Care Act of 2010 and has challenged primary care providers to address gaps in the quality of care provided for patients with mental health issues. Vulnerable populations, such as the American Indian people experience gaps in quality health care, especially communication gaps and language barriers. This quality improvement project used a survey design to explore the potential for primary care providers to adopt a culturally sensitive electronic mental health, screening tool to bridge communication gaps and language barriers. Primary care providers recruited from the Northern Arizona University (NAU) Campus Health Services clinic evaluated the concept of a touch screen iPad technology to implement the Patient Health Questionnaire-9 (PHQ-9), which screens for depression using audio options in English and in the Navajo language to accommodate American Indian patients. A PowerPoint overview of the iPad technology was sent via email to the NAU providers and included; the PHQ-9 screening results, which are to be immediately accessible in the patient's electronic health record along with a screening report. The screening report included the PHQ-9 depression score, interpretation of the score, best treatment choices, and a graph for monitoring patient progress. This survey results concluded providers perceive the iPad technology for mental health screening to be useful in their integrated primary care clinic. A modified Technology Acceptance Model (Davis, 1989) was used to evaluate the providers' perception of the iPad Technology, and the University of Arizona's Qualtrics survey system provided data analysis of the survey results.

A morada dos Wapixana (Arawak) são os campos do nordeste do estado de Roraima. Em sua porção sudeste encontramos a região indígena da Serra da Lua, composta por 17 malocas indígenas com 5.000 Wapixana. Desenvolvemos esta pesquisa por meio da análise toponímica (Dick, 1980, 1999) e etnolingüística (Potier, 1970) das malocas e das paisagens vegetais da região. Objetivamos, desta forma, detalhar a realidade toponímica em suas características denominativas, no conjunto de mapas taxionômicos, dialetológicos, além de um fitogeográfico com os termos em Wapixana. Com isso, procuramos obter a cosmovisão do grupo denominador. Para tanto, dividimos este trabalho em três partes: os fundamentos teóricos; aspectos histórico-geográficos e etnolingüísticos dos campos do Rio Branco; e por último a análise das motivações toponímicas. O resultado das análises demonstrou que os campos ora citados, são frutos da geografia mítica Wapixana, bem como as taxionomias toponímicas preponderantes são os zootopônimos e fitotopônimos. Identificamos três camadas dialetológicas na região: a mais antiga de origem Wapixana;. a segunda, também de origem ameríndia, porém exógena à área de pesquisa, são os nomes de origem Tupi, provindos da Língua Geral Amazônica; e finalmente a portuguesa. / The homeland of the Wapixana (Arawak) are the fields at the northeast region of the state of Roraima. In its southwest portion we find the indigenous region of Serra da Lua, composed by 17 indigenous hamlets, inhabited by 5000 Wapixana. This research was developed through the toponymic (Dick, 1980, 1999) and etnolinguistical (Potier, 1970) of the hamlets and the regional vegetation landscapes. It\'s goal is to detail the toponymic reality in its denominational characteristics in the collection of taxonomical and dialetological maps, as through a phytogeographic map with terms in Wapixana language. This way, the objective is to obtain the cosmovision of the denominating group. This paper was made in three parts: the theoretical fundaments; the historical-geographical and etno-linguistic aspects of the fields of Rio Branco and the analysis of the toponymic motivation. The result of these analyses demonstrates that the mentioned fields are fruit of the Wapixana mythical geography and that the preponderant toponymic taxonomy corresponds to the zootoponyms and phytotoponyms. Three dialetological layers where identified at the region: the oldest, of Wapixana origin; the second, also of Amerindian origin, but exogenous from the research area, with nouns of Tupi roots, prevenient of the Amazonian General Language and, at the end, the Portuguese.

A morada dos Wapixana (Arawak) são os campos do nordeste do estado de Roraima. Em sua porção sudeste encontramos a região indígena da Serra da Lua, composta por 17 malocas indígenas com 5.000 Wapixana. Desenvolvemos esta pesquisa por meio da análise toponímica (Dick, 1980, 1999) e etnolingüística (Potier, 1970) das malocas e das paisagens vegetais da região. Objetivamos, desta forma, detalhar a realidade toponímica em suas características denominativas, no conjunto de mapas taxionômicos, dialetológicos, além de um fitogeográfico com os termos em Wapixana. Com isso, procuramos obter a cosmovisão do grupo denominador. Para tanto, dividimos este trabalho em três partes: os fundamentos teóricos; aspectos histórico-geográficos e etnolingüísticos dos campos do Rio Branco; e por último a análise das motivações toponímicas. O resultado das análises demonstrou que os campos ora citados, são frutos da geografia mítica Wapixana, bem como as taxionomias toponímicas preponderantes são os zootopônimos e fitotopônimos. Identificamos três camadas dialetológicas na região: a mais antiga de origem Wapixana;. a segunda, também de origem ameríndia, porém exógena à área de pesquisa, são os nomes de origem Tupi, provindos da Língua Geral Amazônica; e finalmente a portuguesa. / The homeland of the Wapixana (Arawak) are the fields at the northeast region of the state of Roraima. In its southwest portion we find the indigenous region of Serra da Lua, composed by 17 indigenous hamlets, inhabited by 5000 Wapixana. This research was developed through the toponymic (Dick, 1980, 1999) and etnolinguistical (Potier, 1970) of the hamlets and the regional vegetation landscapes. It\'s goal is to detail the toponymic reality in its denominational characteristics in the collection of taxonomical and dialetological maps, as through a phytogeographic map with terms in Wapixana language. This way, the objective is to obtain the cosmovision of the denominating group. This paper was made in three parts: the theoretical fundaments; the historical-geographical and etno-linguistic aspects of the fields of Rio Branco and the analysis of the toponymic motivation. The result of these analyses demonstrates that the mentioned fields are fruit of the Wapixana mythical geography and that the preponderant toponymic taxonomy corresponds to the zootoponyms and phytotoponyms. Three dialetological layers where identified at the region: the oldest, of Wapixana origin; the second, also of Amerindian origin, but exogenous from the research area, with nouns of Tupi roots, prevenient of the Amazonian General Language and, at the end, the Portuguese.

The thesis explores the possibilities for immersion in a First Nation small community whose language survival hinges on the action by the 5% fluent speakers. Curriculum planning is needed at a time when First Nations do not have the resources or experience in teaching their language as a second language and very limited experience with curriculum development and school administration. The author is familiar with the deep emotional desire for effective language programs but the communities cannot find an effective means for truly successful results. The occasional Native teacher searches for methods by learning linguistic strategies or modeling literate classroom lessons. Community leaders face surmounting obstacles while elders pass away with each crucial decade. These obstacles and constraints are not only due to social ills but also to the attempt at developing curriculum with models which do not origninate with the community, the culture, or the language itself. The thesis therefore attempts to find avenues for blending learning strategies of an oral culture and recognizing and validating the culture which embraces the cultural background to the language. The avenues for language revitalization involve ethnographic research which is seen as practical to the community if these are steps toward cultural development. The social issues level is considered as Native language speakers are often adversely effected due to schooling in residential schools. The thesis then concludes the specific needs for the Ditidaht context as concerns community process, as traditional protocol, and as the nature of an effective curriculum (received in generalized concepts from the community interviews). Other First Nation Community strategies are reviewed from many nations throughout Canada and the United States. The Canadian French immersion experience provides a preview into immersion evolution. The research is found necessary for any First Nation community in search of the crucial need for effective second-language curriculum focus.

The thesis explores the possibilities for immersion in a First Nation small community whose language survival hinges on the action by the 5% fluent speakers. Curriculum planning is needed at a time when First Nations do not have the resources or experience in teaching their language as a second language and very limited experience with curriculum development and school administration. The author is familiar with the deep emotional desire for effective language programs but the communities cannot find an effective means for truly successful results. The occasional Native teacher searches for methods by learning linguistic strategies or modeling literate classroom lessons. Community leaders face surmounting obstacles while elders pass away with each crucial decade. These obstacles and constraints are not only due to social ills but also to the attempt at developing curriculum with models which do not origninate with the community, the culture, or the language itself. The thesis therefore attempts to find avenues for blending learning strategies of an oral culture and recognizing and validating the culture which embraces the cultural background to the language. The avenues for language revitalization involve ethnographic research which is seen as practical to the community if these are steps toward cultural development. The social issues level is considered as Native language speakers are often adversely effected due to schooling in residential schools. The thesis then concludes the specific needs for the Ditidaht context as concerns community process, as traditional protocol, and as the nature of an effective curriculum (received in generalized concepts from the community interviews). Other First Nation Community strategies are reviewed from many nations throughout Canada and the United States. The Canadian French immersion experience provides a preview into immersion evolution. The research is found necessary for any First Nation community in search of the crucial need for effective second-language curriculum focus. / Education, Faculty of / Curriculum and Pedagogy (EDCP), Department of / Graduate