The literature review and synthesis provides a foundation of information for defining key issues for the design and conduct of the Tribal Self-Governance Evaluation Feasibility Study. In addition, the findings will be shared with the Technical Working Group for review and discussion. Our approach to this task was designed broadly to identify, obtain, and assess published and unpublished research and evaluations of Tribal self-governance/management of health and social services programs, focusing specifically on DHHS programs that have been identified as feasible ones to include in a Tribal Self-Governance Demonstration project.
Based on our preliminary literature review conducted as background for the proposal to OASPE, we anticipated that standard literature search techniques would produce a limited number of published studies of the processes and outcomes associated with Tribal self-governance of federal programs. Consequently, the literature search and review methods used for this report include standard literature search techniques and supplementary activities, including:
· Search of internet websites to identify background papers, issue papers, data sources, projects, and studies that have addressed the relevant issues for this project.
· Telephone interviews with researchers who have been involved in studies of American Indian/Alaska Native health and social services programs, to identify past and ongoing research projects and findings that may be relevant to this study.
· Search of websites of federal government agencies that have responsibilities for health, education, employment, and social services to identify relevant data sources, studies, and initiatives for this study.
The first step in the literature survey was to conduct a thorough search of all published literature through standard literature sources, including:
· MedlinePlus: AI/AN Health
· Native Health Research Database
These sources enabled us to identify relevant published literature, from which we compiled a comprehensive bibliography, organized by key topic areas. We then obtained relevant full text and prepared brief abstracts of each publication. As a secondary step, we also searched references cited in each publication to identify additional relevant literature.
Once the published literature bibliography was compiled, we expanded our search through identifying and reviewing websites of national Indian organizations that are concerned with health and social service issues, as well as organizations that are specifically focused on serving and advocating on behalf of AI/AN persons with disabilities. These organizations included:
· National Council of American Indians
· National Indian Health Board
· National Indian Council on Aging
· Association of American Indian Physicians
· National Indian Education Association
In addition, we searched relevant federal government websites  , including:
· Indian Health Service
· Administration for Native Americans
· Administration on Aging
· Administration for Children and Families
· Centers for Medicare & Medicaid Services
· General Accounting Office
After all the literature was synthesized by topic area, with key findings highlighted, we then reviewed each topic area for completeness and “gaps.” The questions addressed in this review included:
1. What do we know with reasonable certainty, based on valid and reliable research?
2. What do the research findings suggest, for which supporting evidence is weaker?
3. What important issues, in this area, have not been addressed by any research?
4. What are the reasons that these issues have not been addressed (e.g. lack of appropriate data)?
This Draft Literature Review includes a summary of findings of this review, limitations and “gaps” in the research and findings, and a discussion of the implications of the findings for the design and conduct of the Tribal Self-Governance Evaluation Feasibility Study.