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Native Americans (NA) disproportionately reside in areas with significantly more social, economic, and health disparities than any other population, and have the lowest employment rates nationally. Additionally, the NA Baby Boomer generation is aging, with senior citizen services largely unavailable on reservations. The Community Elder Caregiver (CEC) Program at Spirit Lake was developed with two aims: 1) to meet the needs of unemployed natives and 2) to develop a competent workforce to help elders safely “age in place”. In the initial pilot, seventeen individuals started the initial (NECC) training, with three completing the Qualified Service Provider (QSP) training. We analyzed the pilot CEC training program using feedback from participants and key stakeholders. We identified components that were successful along with barriers that required alterations to the program design. Market and stakeholder analysis revealed that Certified Nursing Assistant (CNA) training offered broader opportunities for employment than QSP training. In the second iteration, CNA training curriculum was offered in place of QSP. CNA training yielded 8 completions, and 7 additional participants registered for the next session. Key contributors to success included: 1) partnerships with Lake Region State College- TrainND Program, the Spirit Lake Tribal Health Nursing Department, and Next Steps Program social worker; 2) pre-training mentorship of candidates to set goals, expectations, and to help identify and overcome barriers to program completion. Participants also served as a “peer recruitment” strategy.

Conclusion: The CEC pilot resulted in the evolution of a more sustainable, culturally-competent caregiver model that can be expanded to additional reservations.



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