Federal policies created unique barriers to health on the reservation because of forced relocation, colonialism, and exclusionary government practices that persist today. One in three people living on the Navajo Nation lacks running water or electricity, and many face healthcare access challenges due to unpaved roads or a lack of transportation altogether.

Working alongside Navajo patients and providers, the University of Pennsylvania (Penn) and the Indian Health Service (IHS), sought to improve access to cardiovascular care through the implementation of a community-designed telehealth model. Together they implemented patient-driven solutions, such as the integration of Navajo-speaking nurses, and the inclusion of Navajo Wellness Model teachings.

“The community wanted their care to be local, culturally relevant, and accessible,” explained Lauren Eberly, MD, MPH, assistant professor of cardiovascular medicine at Penn and staff cardiologist at the IHS, who led the study.

Researchers scanned electronic health records to identify patients with heart failure diagnoses and invited them to enroll. Each participant received a blood pressure cuff, recommended medications, and biweekly healthcare provider check-ins.

“We sat down with patients and asked how we could make accessing care easier for them and implemented solutions including the use of specific heart medications often underutilized in marginalized populations,” Eberly said.

The Navajo led study resulted in a 53% increase in the use of recommended heart medications and fewer hospitalizations.