The Northern Arizona Healthcare Navajo Video Project

Topic: Addressing the Needs of Specific Patient Populations

The Northern Arizona Healthcare Palliative Care Department recognizes the importance of patient and family understanding of their illnesses. Vital choices arise during serious illnesses, and understanding the risks, benefits and implications of these choices is key to making informed decisions. Many obstacles inhibit clear communication between our Native American patients and hospital staff, from healthcare literacy levels to language and cultural barriers. In an effort to align with and to better support our large Northern Arizona Navajo patient population, we developed the Palliative Care Navajo Video Project.

The Palliative Care team strives to provide accurate and balanced information to all of our patients to promote understanding and shared decision making. In an effort to grow closer to this important goal, we committed to the development of tools to address and overcome the language and cultural barriers complicating communication with our Navajo patient population. The Navajo patient population was chosen as the first focus for our intercultural videos because of the frequency of our interactions, with 35% of our consultation volume comprised of Navajo patients. There are significant cultural and spiritual taboos held by traditional Navajo patients limiting willingness to participate in or end of life discussions. We formed a committee comprised of Palliative Care physicians, nurses, research and media experts as well as certified Navajo interpreters to tackle the job of developing clear, concise, linguistically accurate and culturally sensitive video tools explaining common topics covered in Palliative Care consultations.

Our team determined the topics of highest importance to focus on during the initial project year. These include the following: What is Palliative Care, Understanding Code Status and CPR, Understanding Advance Directives, and Understanding Tracheostomy and Percutaneous Endoscopic Gastrostomy (PEG) Tubes. Original scripts for each video were written by the Palliative Care practitioners, and then revised and edited by interdisciplinary team members. Scripts were then submitted to a group of bilingual clinicians and non-clinicians for cultural sensitivity. Our certified Navajo interpreters then translated the videos into Navajo language. Production, filming, and editing was overseen by NAH Communications and Media team. Each video was recorded in both English and in Navajo.

In the state of Arizona there are 21 tribes and nations located on 26% of Arizona land, comprising nearly 1/8 of all American Indians in The United States. The interface between western and traditional medicine is highlighted for those of us living and working in Northern Arizona. Our hope is that both patients as well as other providers in institutions that serve Native American patients will benefit from the Navajo Video Project.



  • Emmalee Kennedy

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