Abstracts

Rationale: Epilepsy treatment results, especially in minority populations, are influenced by factors other than medications, e.g. knowledge level of the condition, beliefs of the ethnic/cultural group and community attitudes. Hereby we report on these factors on Native American(NA)subjects, i.e. Ojibwa, Lakota and Ho-Chunk, without epilepsy and compare it to non-native americans(NNA)also without epilepsy. Methods: We administered a survey to 33 Native Americans (NA) randomly selected in NA community clinics in Minneapolis and University of Minnesota Neurology clinic, and compared it, using paired t-test, to 115 non-native American adults (NNA),also without epilepsy, and previously studied. The survey measured: knowledge of epilepsy, perception of the care people with epilepsy receive, and current spiritual and other beliefs concerning the condition. Results: Significant difference between the two populations was seen in: 1) age, NA had a median age of 39 /-14 compared to 48 /-15 NNA, 2) female preponderance in NA, 82% NA vs 70%, perhaps reflecting NA population structure, Minnesota NA census, 2000, 3)marriage % was higher in NNA, and 4) secondary and post secondary education level and household income where lower in NA. On items that measured knowledge, NA scored less correctly in etiology and also how to react to anticonvulsants side-effects and effectiveness.They scored equally on knowledge of heritability of epilepsy A spiritual cause of epilepsy belief was higher in NA, although when adjusted for education and age was not significant (p=.08). A less positive perception of health care dimensions, i.e. availability of neurology specialists, ancillary testing (EEG, MRI)and new drugs, was seen among NA, indicating a significant disparity. In spite of the fact that knowledge level was less in NA, community acceptance of the condition was significantly higher for NA but trust of providers was,non-significantly, lower for NA. Conclusions: The data suggests the need for: 1)additional education of NA on epilepsy causes, management 2)acceptance by NNA of the NA beliefs of a spiritual dimension to the condition, and 3)improving availability of specialized services and new medications to NA. Of interest, the younger age of respondents in NA population may imply a trend towards more health care consciousness in the newer generations of NA, especially women, and suggests that lower levels of males accessing medical clinics, an ongoing issue across many populations, may be more prevalent in NA populations.