Addiction & Overdose

Walk Softly and Listen Carefully

March 22, 2024

Throughout the country, American Indian and Alaska Natives are disproportionately impacted by the opioid epidemic. According to the Centers for Disease Control and Prevention, more than 1300 Indigenous people died by overdose in 2021, the highest rate of any racial or ethnic group at the time. To address this disparity the California Bridge Program, advised by Melissa Walls, PhD, Associate Professor in American Health in the Center for Indigenous Health at the Johns Hopkins Bloomberg School of Public Health, developed a project to increase access to treatment for opioid use disorder among Native populations in California. 

The California Native Project, supported by the Bloomberg American Health Initiative, leveraged patient navigators in emergency departments to increase treatment for opioid use disorder. Patient navigators, or people who help patients communicate their needs and questions to healthcare providers, can play an important role in connecting patients with treatment and other resources. 

The project team identified seven emergency departments in California that had the highest rates of overdose-related deaths among Native individuals. The patient navigators in the emergency departments at the hospitals completed specialty training to better understand California tribal history, learn contemporary cultural awareness, and improve skills for allyship. The group was also coached to effectively integrate this learning into community outreach activities, education, and engagement within their own emergency departments.

Through this project, the California Bridge Program successfully established strong partnerships between patient navigators and local tribal health organizations, learning to “walk softly and listen carefully” to the unique needs of this population. These connections laid the foundation for future trainings, partnerships, and materials to address the Native American opioid overdose crisis.


Click here to read the 2012 NCAI Brief titled "Walk Softly and Listen Carefully: Building research relationships with Tribal communities."

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