# Healthcare-Seeking and Violence against American Indian and Alaska Native Women: Examining the Impact of the COVID-19 Pandemic

> **NIH NIH R01** · PACIFIC INSTITUTE FOR RES AND EVALUATION · 2022 · $231,902

## Abstract

PROJECT SUMMARY/ABSTRACT
In response to the Notice of Special Interest (NOT-OD-22-031) for “Research on the Health of Women of
Understudied, Underrepresented, and Underreported (U3) Populations,” we propose to apply resources from
our parent R01 project to examine rates of injurious violence from hospital discharge data for American
Indian/Alaska Native (AIAN) women residing on and off American Indian reservations; assess these rates
within the context of the COVID-19 pandemic conditions; and utilize results of interviews with key Tribal
leaders to interpret results in ways that are valid and useful for Tribal policymakers. With mounting reports of
Missing and Murdered Indigenous Women, there is a profound need to expand the capacity of research on
gender-based violence to account for the contexts, risks, and services underlying intimate partner violence,
domestic violence, and sexual assault. The parent project uses Healthcare Cost and Utilization Project (HCUP)
data to perform geospatial analyses across multiple states that are collocated with American Indian
reservations populated with at least 2,000 residents. The proposed supplement will investigate injuries
associated with gender-based violence specifically for AIAN women whose agency and needs have been
historically and continually understudied, underrepresented, and underreported in research. Guided by
research that has demonstrated the utility of the HCUP to address intimate partner violence and domestic
violence among other groups of women, this supplemental study aligns with the priorities established by the
Office of Research on Women's Health regarding disparities related to violence against Indigenous women.
We adopt a multi-methods and intersectional approach to achieve the following aims: AIM 1: Assess the type
and frequency of hospital discharge records coded for violence, such as assault and battery committed by
intimate partners and unknown assailants, for AIAN women residing on versus off Tribal jurisdictions collocated
with Arizona by using HCUP data from 2006-2019 (preceding the COVID-19 pandemic). AIM 2: Compare
these reports of care-seeking within the scope of the COVID-19 pandemic conditions using HCUP data from
2020. AIM 3: Identify how Tribal community conditions and Tribal services may inform our understanding of the
violence-related reporting and impacts of the COVID-19 pandemic control measures using interview data from
key leaders. In doing so, this supplemental research addresses the call for creating culturally and contextually
relevant evidence that considers the landscape of geographic and structural factors to primary and
preventative care and centers the lived experiences of AIAN women to meet group- and population-level
needs.

## Key facts

- **NIH application ID:** 10559049
- **Project number:** 3R01AA028236-02S1
- **Recipient organization:** PACIFIC INSTITUTE FOR RES AND EVALUATION
- **Principal Investigator:** JULIET P LEE
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $231,902
- **Award type:** 3
- **Project period:** 2021-03-05 → 2024-02-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10559049

## Citation

> US National Institutes of Health, RePORTER application 10559049, Healthcare-Seeking and Violence against American Indian and Alaska Native Women: Examining the Impact of the COVID-19 Pandemic (3R01AA028236-02S1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10559049. Licensed CC0.

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