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Okamoto SK, Okamura KH, Marshall SM, Chin SK, Carson AB, An KJ, Song SD, Saladino PA, Prado G, Kulis SS. Examining implementation determinants of a culturally grounded, school-based prevention curriculum in rural Hawai'i: A test development and validation study. IMPLEMENTATION RESEARCH AND PRACTICE 2024; 5:26334895241262823. [PMID: 39050583 PMCID: PMC11268022 DOI: 10.1177/26334895241262823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Background This study examined the implementation determinants of a culturally grounded, school-based drug prevention curriculum in rural Hawai'i. Test development and validation procedures were used to examine the impact of implementation barriers and facilitators of the curriculum in public or charter middle/intermediate schools on Hawai'i Island. Method A five-phase, mixed-methods approach toward test development and validation was used. These phases included item generation (Phase 1), item refinement and selection (Phase 2), item reduction (Phase 3), reliability testing (Phase 4), and validity testing (Phase 5). Educational administrators, teachers, and staff employed by the Hawai'i State Department of Education (HIDOE) participated in the study. Results Phases 1 and 2 yielded 50 implementation barriers and 27 implementation facilitators that were evaluated by 204 HIDOE administrators, teachers, and staff. Factor analysis of the barrier items indicated a four-factor solution: (1) Innovation Barriers, (2) HIDOE State-Level Barriers, (3) Teacher-Level Barriers, and (4) Administrator-Level Barriers. Mean comparisons indicated that several barrier and facilitator items differentiated teachers from administrators in the sample. Conclusions This study contributes to the implementation measurement literature, specifically in the areas of mental health and substance use. It also highlights the importance of addressing multiple contextual levels in the implementation of culturally focused prevention interventions. Plain Language Summary Title Examining Implementation Barriers and Facilitators for School-Based Prevention in Hawai'i. Plain Language Summary Compared with other major ethnic groups, Native Hawaiian and Pacific Islander (NHPI) youth have substantially higher rates of substance use and higher adverse mental and physical health effects related to their use. Despite these disparities, educational and community-based practitioners have long struggled with implementing and sustaining promising substance use interventions for NHPI youth. This study contributes to our understanding of measuring implementation barriers and facilitators for substance use prevention for NHPI youth in rural school settings. It contributes to the field of health disparities and health equity promotion, by addressing calls for research to understand factors affecting successful implementation of prevention programs. This is critical toward achieving health equity for underrepresented and vulnerable populations, such as NHPI and rural youth.
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Affiliation(s)
- Scott K. Okamoto
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Kelsie H. Okamura
- Implementation Research Division, The Baker Center for Children and Families, Roxbury Crossing, MA, USA
| | - Sarah Momilani Marshall
- Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, USA
| | - Steven Keone Chin
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Adabelle B. Carson
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Katlyn J. An
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Sarah D. Song
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Paula Angela Saladino
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | | | - Stephen S. Kulis
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
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Schick MR, Todi AA, Nalven T, Spillane NS. Discrimination and school outcomes in first nation youth: The role of positive psychological characteristics. J Adolesc 2023; 95:1653-1665. [PMID: 37655638 PMCID: PMC10926939 DOI: 10.1002/jad.12233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/03/2023] [Accepted: 08/05/2023] [Indexed: 09/02/2023]
Abstract
INTRODUCTION Positive psychological characteristics have been found to be associated with discrimination and school outcomes separately; however, no work has examined these associations together or in North American Indigenous (NAI) populations. NAI adolescents experience high rates of racial discrimination. Because discrimination has a detrimental impact on academic outcomes it is critical to identify factors that could buffer this impact. The purpose of this study was to examine the indirect effect of racial discrimination on three distinct school outcomes (i.e., attitudes toward school, grades, and educational attainment goals) through the pathway of three positive psychological characteristics (i.e., satisfaction with life, subjective happiness, and self-compassion). METHODS First Nation adolescents living on a rural reserve in Eastern Canada (N = 106, Mage = 14.6 years, 50.0% female) completed a pencil-and-paper survey in Spring 2017 as part of a larger community-based participatory research study. RESULTS In the model examining school attitudes, indirect effects through subjective happiness (b = -0.21, 95% confidence interval (CI): [-0.53, -0.03]) and self-compassion (b = -0.19, 95% CI: [-0.39, -0.04]), but not satisfaction with life, were significant. In the model examining grades, only the specific indirect effect through subjective happiness was significant (b = -0.27, 95% CI: [-0.59 -0.07]). Similarly, in the model examining school goals, only the indirect effect through subjective happiness was significant (b = -0.40, 95% CI: [-0.94, -0.08]). The direct effects of discrimination on school attitudes (b = 0.02, 95% CI: [-0.52, 0.56]), grades (b = 0.16, 95% CI: [-0.39, 0.71]), and school goals (b = -0.03, 95% CI: [-0.90, 0.84]) were not significant after controlling for positive psychological characteristics. DISCUSSION Schools should foster positive emotions to enhance academic outcomes, especially for NAI youth who are more likely to experience racial discrimination.
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Affiliation(s)
- Melissa R. Schick
- PATHS Lab, University of Rhode Island, Department of Psychology, Kingston RI 02881
- Division of Prevention and Community Research, Yale School of Medicine, New Haven CT, 06511
| | | | - Tessa Nalven
- PATHS Lab, University of Rhode Island, Department of Psychology, Kingston RI 02881
| | - Nichea S. Spillane
- PATHS Lab, University of Rhode Island, Department of Psychology, Kingston RI 02881
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Dalisay F, Pokhrel P, Santos J, Mori E, Kawabata Y, Beltran Z, Ooka G, Okamoto SK. Guam Adolescents' Use of Strategies to Resist Cigarette, e-Cigarette, and Betel Nut Offers: Findings from a Focus Group Study. Subst Use Misuse 2023; 58:1580-1586. [PMID: 37488091 PMCID: PMC10861142 DOI: 10.1080/10826084.2023.2236205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Background: This study examined resistance strategies used by predominantly Pacific Islander young adolescents in response to offers of tobacco, e-cigarettes, and betel [areca] nuts. This study was intended to inform the development of a prevention curriculum focused on training young adolescents from the U.S.-Affiliated Pacific Islands (USAPI) on culturally appropriate strategies to resist substance use offers. Currently, very little is understood in terms of how Pacific Islander youths deal with tobacco and other substance use offers, although the use of tobacco products among Pacific Islander youths is high. Specifically, given the collectivist sociocultural orientation of the Pacific Islander communities, it is unclear whether the direct (overt) confrontational style of resistance is a viable mode of resistance for youths to practice when faced with a substance use offer. Methods: We conducted 10 focus groups with public middle school students (N = 34) from Guam, which is part of the USAPI. Results: Results suggested that, as with other communities in the U.S., the resistance strategies fall into two categories-overt/confrontational and non-confrontational resistance strategies. Overt/confrontational strategies included (a) saying "no" and (b) verbally confronting the offeror. Non-confrontational strategies included (a) avoiding or leaving the situation and (b) telling an adult. Conclusions: Our findings have implications for the development of culturally grounded interventions aimed at preventing youth tobacco and other substance use in Guam, the USAPI, and the Pacific region.
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Affiliation(s)
- Francis Dalisay
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Pallav Pokhrel
- Population Sciences in the Pacific Program, University of Hawai’i Cancer Center, University of Hawai’i at Mānoa, Honolulu, Hawai’i, USA
| | - Jean Santos
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Elua Mori
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Yoshito Kawabata
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Zhantelle Beltran
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Gabrielle Ooka
- College of Liberal Arts & Social Sciences, University of Guam, UOG Station, Mangilao, Guam, USA
| | - Scott K. Okamoto
- Population Sciences in the Pacific Program, University of Hawai’i Cancer Center, University of Hawai’i at Mānoa, Honolulu, Hawai’i, USA
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Rink E, Anastario M, Peterson M, FireMoon P, Johnson O, GrowingThunder R, Ricker A, Cox G, Holder S, Baldwin JA. Baseline results from NenŨnkUmbi/EdaHiYedo: A randomized clinical trial to improve sexual and reproductive health among American Indian adolescents. J Adolesc 2023; 95:844-859. [PMID: 36890753 PMCID: PMC11290810 DOI: 10.1002/jad.12158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 03/10/2023]
Abstract
We report on baseline findings from NenUnkUmbi/EdaHiYedo, a community based participatory research randomized controlled trial with American Indian adolescents to reduce sexual and reproductive health disparities. American Indian adolescents aged 13-19 years participated in a baseline survey that was administered in five schools. We used zero-inflated negative binomial regression to evaluate how the count of protected sexual acts was associated with independent variables of interest. We stratified models by self-reported gender of adolescents and tested for a two-way interaction effect between gender and the independent variable of interest. Two hundred twenty-three girls and 222 boys (n = 445) were sampled. The average number of lifetime partners was 1.0 (standard deviation = 1.7). Each additional lifetime partner was associated with a 50% increase in the number of protected sexual acts incident rate ratio (IRR = 1.5, 95% confidence interval [CI] 1.1-1.9) and more than a twofold increase in the likelihood of not having protected sexual acts (adjusted odd ratio [aOR] = 2.6, 95% CI 1.3-5.1). Each additional number of substances used in adolescentss' lifetime was associated with an increased likelihood of not having protected sexual acts (aOR = 1.2, 95% CI 1.0-1.5). In boys, each one standard deviation increase in depression severity was associated with a 50% reduction in the number of times a condom was used adjusted IRR (aIRR = 0.5, 95% CI 0.4-0.6, p < .001). Each 1-unit increase in positive prospections of pregnancy was associated with a pronounced decrease likelihood of not having protected sexual acts (aOR = 0.01, 95% CI 0.0-0.1). Findings support the importance of tribally driven tailoring of sexual and reproducive health interventions and services for American Indian adolescents.
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Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Mike Anastario
- Robert Stempel College of Public Health & Social Work, Florida International University, Florida, Miami, USA
| | - Malory Peterson
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | | | | | - Ramey GrowingThunder
- Language and Culture Department, Fort Peck Assiniboine and Sioux Tribes, Poplar, Montana, USA
| | - Adriann Ricker
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Genevieve Cox
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Shannon Holder
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Julie A Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, Arizona, USA
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Boyd RC, Castro FG, Finigan-Carr N, Okamoto SK, Barlow A, Kim BKE, Lambert S, Lloyd J, Zhang X, Barksdale CL, Crowley DM, Maldonado-Molina M, Obasi EM, Kenney A. Strategic Directions in Preventive Intervention Research to Advance Health Equity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 24:577-596. [PMID: 36469162 PMCID: PMC9734404 DOI: 10.1007/s11121-022-01462-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2022] [Indexed: 12/09/2022]
Abstract
As commissioned by the Society for Prevention Research, this paper describes and illustrates strategic approaches for reducing health inequities and advancing health equity when adopting an equity-focused approach for applying prevention science evidence-based theory, methodologies, and practices. We introduce an ecosystemic framework as a guide for analyzing, designing, and planning innovative equity-focused evidence-based preventive interventions designed to attain intended health equity outcomes. To advance this process, we introduce a health equity statement for conducting integrative analyses of ecosystemic framework pathways, by describing the role of social determinants, mechanisms, and interventions as factors directly linked to specific health equity outcomes. As background, we present health equity constructs, theories, and research evidence which can inform the design and development of equity-focused intervention approaches. We also describe multi-level interventions that when coordinated can produce synergistic intervention effects across macro, meso, and micro ecological levels. Under this approach, we encourage prevention and implementation scientists to apply and extend these strategic directions in future research to increase our evidence-based knowledge and theory building. A general goal is to apply prevention science knowledge to design, widely disseminate, and implement culturally grounded interventions that incrementally attain specific HE outcomes and an intended HE goal. We conclude with recommendations for conducting equity-focused prevention science research, interventions, and training.
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Affiliation(s)
- Rhonda C Boyd
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | | | - Allison Barlow
- John Hopkins Center for American Indian Health, Baltimore, MD, USA
| | | | | | - Jacqueline Lloyd
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, USA
| | - Xinzhi Zhang
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Crystal L Barksdale
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | - Anne Kenney
- John Hopkins Center for American Indian Health, Baltimore, MD, USA
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Summerton J, Blunden S. Cultural interventions that target mental health and wellbeing for First Nations Australians: a systematic review. AUSTRALIAN PSYCHOLOGIST 2022. [DOI: 10.1080/00050067.2022.2130026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jaimi Summerton
- College of Psychology, Central Queensland University, Rockhampton, Australia
| | - Sarah Blunden
- College of Psychology, Central Queensland University, Rockhampton, Australia
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Subica AM, Guerrero EG, Hong P, Aitaoto N, Moss HB, Iwamoto DK, Wu LT. Alcohol Use Disorder Risk and Protective Factors and Associated Harms Among Pacific Islander Young Adults. J Racial Ethn Health Disparities 2022; 9:1818-1827. [PMID: 34378172 PMCID: PMC9048749 DOI: 10.1007/s40615-021-01118-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 11/26/2022]
Abstract
Pacific Islander (PI) young adults (age 18 to 30 years) experience elevated rates of hazardous drinking, AUDs, and alcohol-related harms. Yet, we know little about the risk and protective factors that drive, or can prevent, PI young adult hazardous drinking behaviors and AUDs due to a lack of targeted alcohol disparities research. This large qualitative study presents data from 8 focus groups with 69 PIs (51 young adults, 18 informal providers) to explore the major risk factors, protective factors, and negative consequences associated with PI young adult hazardous drinking and AUDs. Findings revealed (1) major risk factors including the presence of significant life stressors that trigger alcohol self-medication, peer/social pressure to drink, permissive drinking norms, and frequent access to alcohol and (2) negative consequences involving physical fights, health and relationship problems, harm to personal reputation, and community harms including driving-under-the-influence and sexual violence. Protective factors against hazardous drinking and AUDs included the cultural norm of protecting the family's reputation by avoiding AUDs, church/religious faith, family responsibilities, and culturally relevant prosocial activities (e.g., sports, dance, choir). Obtaining this in-depth data revealed that an effective culturally grounded AUD prevention intervention for PI young adults-which does not currently exist-should (1) target these identified major risk factors for AUDs, while (2) integrating culturally responsive strategies that incorporate their reported protective factors.
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Affiliation(s)
- Andrew M Subica
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, 900 University Ave, Riverside, CA, 92521, USA.
| | - Erick G Guerrero
- Research to End Healthcare Disparities Corp, I-Lead Institute, Santa Monica, USA
| | - Phong Hong
- School of Public Policy, University of Michigan, Ann Arbor, USA
| | - Nia Aitaoto
- College of Health, University of Utah, Salt Lake City, USA
| | - Howard B Moss
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside, 900 University Ave, Riverside, CA, 92521, USA
| | - Derek K Iwamoto
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Li-Tzy Wu
- School of Medicine, Duke University, Durham, NC, USA
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Hunter AM, Carlos M, Nuño VL, Tippeconnic‐Fox MJ, Carvajal S, Yuan NP. Native Spirit: Development of a culturally grounded after-school program to promote well-being among American Indian adolescents. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:242-251. [PMID: 35194803 PMCID: PMC9544255 DOI: 10.1002/ajcp.12590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/04/2022] [Accepted: 01/13/2022] [Indexed: 06/10/2023]
Abstract
Culturally grounded after-school programs (ASPs), based on local cultural values and practices, are often developed and implemented by and for the local community. Culturally grounded programs promote health and well-being for American Indian and Alaska Native (AI/AN) adolescents by allowing them to reconnect to cultural teachings that have faced attempted historical and contemporary erasure. This article is a first-person account that describes the development and implementation of a culturally grounded ASP, Native Spirit (NS), for AI adolescents (grades 7-12) living on a Southwest urban-based reservation. NS, a 13-session culturally grounded ASP, was developed by an academic-community partnership that focuses on increasing cultural engagement as a form of positive youth development. Each session was guided by one to two local cultural practitioners and community leaders. The development of the NS program contributed to an Indigenous prevention science that emphasizes the positive impacts of Indigenous culture and community on health and well-being. The use of the ASP format, in partnership with the Boys & Girls Club, increased the feasibility of dissemination and refinement of the NS program by tribal communities and organizations.
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Affiliation(s)
- Amanda M. Hunter
- Center for Health Equity ResearchNorthern Arizona UniversityFlagstaffArizonaUSA
| | - Mikah Carlos
- Salt River Pima Maricopa Indian CommunityYouth Services DepartmentScottsdaleArizonaUSA
| | - Velia L. Nuño
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
| | - Mary Jo Tippeconnic‐Fox
- Department of American Indian Studies, College of Social & Behavioral SciencesUniversity of ArizonaTucsonArizonaUSA
| | - Scott Carvajal
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
| | - Nicole P. Yuan
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
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Rink E, Firemoon P, Anastario M, Johnson O, GrowingThunder R, Ricker A, Peterson M, Baldwin J. Rationale, Design, and Methods for Nen Unkumbi/Edahiyedo ("We Are Here Now"): A Multi-Level Randomized Controlled Trial to Improve Sexual and Reproductive Health Outcomes in a Northern Plains American Indian Reservation Community. Front Public Health 2022; 10:823228. [PMID: 35910931 PMCID: PMC9326233 DOI: 10.3389/fpubh.2022.823228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/29/2022] [Indexed: 12/01/2022] Open
Abstract
American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities.
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Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | | | - Michael Anastario
- AHC5, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | | | - Ramey GrowingThunder
- Language and Culture Department, Fort Peck Assiniboine and Sioux Tribes, Poplar, MT, United States
| | - Adriann Ricker
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Malory Peterson
- Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
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Venner KL, Hernandez-Vallant A, Hirchak KA, Herron JL. A scoping review of cultural adaptations of substance use disorder treatments across Latinx communities: Guidance for future research and practice. J Subst Abuse Treat 2022; 137:108716. [PMID: 35148923 PMCID: PMC9086178 DOI: 10.1016/j.jsat.2021.108716] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/26/2021] [Accepted: 12/14/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Much of the substance use disorder (SUD) treatment efficacy and effectiveness research is lacking consensus on which scientifically rigorous approach to employ for culturally adapting evidence-based treatments (EBTs) and evidence-based preventions (EBPs) for SUDs among Latinx communities. The aim of this paper is to provide a scoping review of the literature on cultural adaptations of SUD treatment for Latinx communities. METHODS We examined the justifications for cultural adaptations, processes of adaptations, cultural adaptations described, and efficacy and effectiveness of culturally adapted SUD interventions. The study followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Inclusion criteria consisted of whether the intervention had been culturally adapted based upon an existing EBT or EBP for SUD. Through the search of four databases, expert knowledge and reviewing the reference list of applicable articles, 30 articles met inclusion criteria, which included 14 treatment or prevention outcome articles, one single group pre-post study article, and 15 methods papers on cultural adaptations. Justifications for cultural adaptations centered on SUD health inequities among Latinx populations. RESULTS Four research groups employed adaptation models to culturally tailor evidence-based interventions and most often used elements of community-based participatory research (CBPR). Using Bernal, Bellido, & Bonilla's (1995) Ecological Validity Framework of eight dimensions, the most common cultural adaptations centered on language, context, content, and persons. Efficacy trials with Latinx populations are nascent though growing and reveal: (1) significant time effects for EBTs and most EBPs, (2) superior SUD outcomes for culturally adapted EBTs compared to standard EBTs or other comparison conditions by three research groups, (3) significant prevention intervention effects by three research groups, and (4) significant cultural or social moderators by two groups suggesting Latinx with higher cultural identity, parental familism, or baseline discrimination improve significantly more in the culturally adapted EBTs. CONCLUSION These findings suggest that the science of culturally adapting EBTs is improving in rigor with the use of models to guide the work and the conduct of clinical trials. Measurement of cultural and social variables allows for tests of moderation to understand for whom cultural adaptations are most effective. Future hybrid efficacy/effectiveness trials and implementation research should continue moving the science of cultural adaptation forward.
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Affiliation(s)
- Kamilla L Venner
- University of New Mexico, MSC03 2220, Albuquerque, NM 87131, United States.
| | | | - Katherine A Hirchak
- Washington State University, Elson S. Floyd College of Medicine, United States.
| | - Jalene L Herron
- University of New Mexico, MSC03 2220, Albuquerque, NM 87131, United States; University of New Mexico, Center on Alcohol, Substance Use, and Addictions, United States.
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11
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Hunter A, Carlos M, Muniz FB, Leybas Nuño V, Tippeconnic Fox MJ, Carvajal S, Lameman B, Yuan N. Participation in a Culturally Grounded Program Strengthens Cultural Identity, Self-esteem, and Resilience in Urban Indigenous Adolescents. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2022; 29:1-21. [PMID: 35255147 PMCID: PMC10726381 DOI: 10.5820/aian.2901.2022.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Culturally grounded after-school programs (ASPs) aim to promote health and well-being among Indigenous youth. Native Spirit is a 10-session ASP that focuses on local cultural values and activities facilitated by local cultural practitioners. This pilot study used a single group, pretest-posttest design (N = 18) with Indigenous adolescents in grades 7-12 and conducted participant interviews (N = 11) to assess the impact of the program on cultural identity, self-esteem, and resilience. There were immediate post-program increases in mean strength in cultural identity (p = 0.002), resilience (p = 0.161), and self-esteem (p = 0.268). Themes related to benefits of program participation included curiosity and commitment to cultural identity, increases in self-esteem, and ability to build resilience. This study provides new insights on the relationship between cultural engagement and adolescent health.
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12
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Bussalleu A, Pizango P, King N, Ford J, Team IHACCR, Harper SL. Kaniuwatewara (when we get sick): understanding health-seeking behaviours among the Shawi of the Peruvian Amazon. BMC Public Health 2021; 21:1552. [PMID: 34399726 PMCID: PMC8365975 DOI: 10.1186/s12889-021-11574-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/29/2021] [Indexed: 11/21/2022] Open
Abstract
Background Detailed qualitative information regarding Indigenous populations’ health-seeking behaviours within Peru’s plural healthcare system is lacking. Such context-specific information is prerequisite to developing evidence-based health policies and programs intended to improve health outcomes for Indigenous populations. To this end, this study aimed to characterize health-seeking behaviours, factors affecting health-seeking behaviours, and barriers to obtaining healthcare in two Indigenous Shawi communities in Peru. Methods Community-based approaches guided this work, and included 40 semi-structured interviews and a series of informal interviews. Data were analysed thematically, using a constant comparative method; result authenticity and validity were ensured via team debriefing, member checking, and community validation. Results Shawi health-seeking behaviours were plural, dynamic, and informed by several factors, including illness type, perceived aetiology, perceived severity, and treatment characteristics. Traditional remedies were preferred over professional biomedical healthcare; however, the two systems were viewed as complementary, and professional biomedical healthcare was sought for illnesses for which no traditional remedies existed. Barriers impeding healthcare use included distance to healthcare facilities, costs, language barriers, and cultural insensitivity amongst professional biomedical practitioners. Nevertheless, these barriers were considered within a complex decision-making process, and could be overridden by certain factors including perceived quality or effectiveness of care. Conclusions These findings emphasize the importance of acknowledging and considering Indigenous culture and beliefs, as well as the existing traditional medical system, within the professional healthcare system. Cultural competency training and formally integrating traditional healthcare into the official healthcare system are promising strategies to increase healthcare service use, and therefore health outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11574-2.
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Affiliation(s)
- Alejandra Bussalleu
- Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, Honorio Delgado, 430, Lima, Peru.
| | - Pedro Pizango
- Communidad Nativa Balsapuerto, Alto Amazonas, Communidad Nativa, Loreto, Peru
| | - Nia King
- Department of Population Medicine, University of Guelph, 50 Stone Road East, Guelph, Ontario, Canada.,Department of Medicine, Queen's University, 99 University Avenue, Kingston, Ontario, Canada
| | - James Ford
- Priestly International Centre for Climate, University of Leeds, Leeds, UK.,Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford, Cesar Carcamo, Patricia Garcia, Shuaib Lwasa, Didacus B. Namanya, Edmonton, Canada
| | - I H A C C Research Team
- Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford, Cesar Carcamo, Patricia Garcia, Shuaib Lwasa, Didacus B. Namanya, Edmonton, Canada
| | - Sherilee L Harper
- Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford, Cesar Carcamo, Patricia Garcia, Shuaib Lwasa, Didacus B. Namanya, Edmonton, Canada.,School of Public Health, University of Alberta, 116 St & 85 Ave, Edmonton, Alberta, Canada
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Bussalleu A, King N, Pizango P, Ford J, Carcamo CP, Harper SL. Nuya kankantawa (we are feeling healthy): Understandings of health and wellbeing among Shawi of the Peruvian Amazon. Soc Sci Med 2021; 281:114107. [PMID: 34153933 DOI: 10.1016/j.socscimed.2021.114107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/19/2021] [Accepted: 06/02/2021] [Indexed: 11/25/2022]
Abstract
Promoting and supporting Indigenous health includes ensuring health services reflect local concepts of health. There is, therefore, a need to better understand context-specific Indigenous understandings of health in order to design culturally appropriate health services. To this end, this study characterized two Shawi communities' understandings of what it means to be healthy. Using a community-based participatory research approach, 40 semi-structured interviews and a series of informal interviews were conducted and analysed thematically, using a constant comparative method. The Shawi definition of health extended beyond individual physical welfare and focused on emotional, collective, and environmental wellbeing. The primary factors underlying Shawi perceptions of health and wellbeing included providing for the family, ensuring the welfare of others, maintaining positive social relationships, preserving traditional values and practices, and living harmoniously with the natural environment. Conversely, Shawi classified illnesses according to their cause or treatment. These included illnesses caused by sorcery, those caused by spirits of the forest, and 'new diseases,' that first appeared in the communities when they were contacted by the Western civilization, for which no traditional remedies existed. Consequently, according to Shawi, sociocultural, environmental, and climatic changes are posing imminent health threats. This study highlights the differences between biomedical and Indigenous Shawi health understandings, and therefore emphasizes the importance of acknowledging and embracing Shawi culture and beliefs within the formal healthcare system.
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Affiliation(s)
- Alejandra Bussalleu
- Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, Honorio Delgado 430, Lima, Peru
| | - Nia King
- School of Medicine, Queen's University, 15 Arch Street, Kingston, Ontario, Canada; School of Public Health, University of Alberta, 116 St & 85 Ave, Edmonton, Alberta, Canada.
| | - Pedro Pizango
- Communidad Nativa Balsapuerto, Alto Amazonas, Loreto, Peru
| | - James Ford
- Priestly International Centre for Climate, University of Leeds, Leeds, UK; Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford Cesar Carcamo Patricia Garcia Shuaib Lwasa Didacus B. Namanya, Canada
| | - Cesar P Carcamo
- Faculty of Public Health and Administration, Universidad Peruana Cayetano Heredia, Honorio Delgado 430, Lima, Peru; Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford Cesar Carcamo Patricia Garcia Shuaib Lwasa Didacus B. Namanya, Canada
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- Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford Cesar Carcamo Patricia Garcia Shuaib Lwasa Didacus B. Namanya, Canada
| | - Sherilee L Harper
- School of Public Health, University of Alberta, 116 St & 85 Ave, Edmonton, Alberta, Canada; Indigenous Health Adaptation to Climate Change Research Team: Lea Berrang-Ford Cesar Carcamo Patricia Garcia Shuaib Lwasa Didacus B. Namanya, Canada
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Kristjansson AL, Davis SM, Coffman J, Mills R. Icelandic Prevention Model for Rural Youth: A Feasibility Study in Central Appalachia. Health Promot Pract 2021; 23:397-406. [PMID: 33771042 DOI: 10.1177/15248399211002827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to assess the feasibility of implementing the Icelandic model for Primary Substance Use Prevention (IPM) in rural Central Appalachia. Guided by the IPM's theoretical framework, 26 stakeholders from a single county in West Virginia were purposefully recruited during the spring of 2019 and divided into four focus groups. Interviews were recorded and transcribed verbatim and analyzed into themes based on IPM premises. Focus group material produced seven themes: Drug use overall, Drug treatment and other service needs, Poverty, Parenting/Caregiver practices, Transportation, Downtime/Leisure time activities, and Opportunities for solutions. General support was found for the potential of the IPM in the region. Preferably, the implementation of the model should coincide with attention to the adult population as drug use was reported to be plaguing the whole community. Treatment options were few and mostly far away. General poverty and lack of public transportation further stifled progress and potential for change. Organized leisure time activities and programs for youth were scarce and mostly seasonal. Suggested solutions for the adult community included workforce and skill training, coupled with increased opportunities for organized leisure activities for youth, and access to healthy role models via schools and faith-based organizations. We conclude that implementation of the IPM would be feasible to prevent substance use initiation and progression among youth in the rural Central Appalachia. We present several specific recommendations for policy and practice that address factors unique to this environment to initiate the IPM implementation development and suggest initial model application strategies.
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Ivanich JD, Mousseau AC, Walls M, Whitbeck L, Whitesell NR. Pathways of Adaptation: Two Case Studies with One Evidence-Based Substance Use Prevention Program Tailored for Indigenous Youth. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 21:43-53. [PMID: 29876790 DOI: 10.1007/s11121-018-0914-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Indigenous communities often face disproportionate challenges across a variety of health domains, and effective prevention strategies are sorely needed. Unfortunately, evidence is scant regarding what approaches are effective for these communities. A common approach is to take an evidence-based practice or program with documented effectiveness in other populations and implement it with Indigenous populations. While a science of intervention adaptation is emerging, there remains little guidance on processes for adaptation that strategically leverage both existing scientific evidence and Indigenous prevention strategies. In this paper, two case studies illustrate promising practices for adaptation, documenting the approaches of two research teams funded under the National Institutes of Health's initiative to support Intervention Research to Improve Native American Health (IRINAH). These teams worked with distinct Indigenous populations in the USA and Canada to culturally adapt the same prevention program, the Iowa Strengthening Families Program for Parents and Youth 10-14. The approaches of these two teams and the programs that resulted are compared and contrasted, and critical elements of adaptation in partnership with Indigenous communities are discussed.
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Affiliation(s)
- Jerreed D Ivanich
- Department of Sociology, University of Nebraska-Lincoln, 204 Benton Hall, Lincoln, NE, 68588, USA
| | - Alicia C Mousseau
- National Native Children's Trauma Center, University of Montana, 32 Campus Drive, Missoula, MT, 59812, USA
| | - Melissa Walls
- University of Minnesota Medical School, Duluth Campus. 1035 University Drive, 235 SMed, Duluth, MN, 55812, USA
| | - Les Whitbeck
- Department of Sociology, University of Nebraska-Lincoln, 204 Benton Hall, Lincoln, NE, 68588, USA
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, MS F800, 13055 E. 17th Avenue, Room 333, Aurora, CO, 80045, USA.
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Zambrano A, Garcés G, Olate MP, Treumún M, Román F. Construction of an intercultural preventive strategy of alcohol use in rural Mapuche communities: A community-based participatory research. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:166-185. [PMID: 32906210 DOI: 10.1002/jcop.22440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 08/10/2020] [Accepted: 08/13/2020] [Indexed: 06/11/2023]
Abstract
The research presented in this paper consists of a case study that analyses the elements necessary for a culturally grounded methodological strategy for the prevention of problematic alcohol consumption in rural Mapuche communities in the Araucanía region. To do this, we proposed to answer the questions: what are the particularities that alcohol consumption adopts in the local space? And what are the elements that should be considered for an intercultural preventive strategy for alcohol consumption? Oriented to the perspective of community-based participatory research, data were collected through group interviews with the local community, participant observation and in-depth interviews with people who consumed alcohol, were recovering from consumption and nondrinkers. A total of 84 people participated and the information gathered was analysed using ATLAS.ti software. The results show key aspects that must be considered for the design, including: strengthening the cultural identity, providing spaces for shared reflection in places where the community converges (schools and rural health centres), and problematising alcohol consumption from their own conceptions of normal and problematic consumption. Therefore, there is a need to focus on strengthening intracultural processes in community spaces, with a preventive strategy within the logic of action research, with increasing degrees of community participation.
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Affiliation(s)
- Alba Zambrano
- Department of Psychology, Universidad de La Frontera, Temuco, Chile
| | | | - María P Olate
- Department of Psychology, Magíster y Especialización en Psicología Comunitaria, Universidad de La Frontera, Temuco, Chile
| | | | - Francisca Román
- Department of Psychology, Universidad de La Frontera, Temuco, Chile
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Gameon JA, Skewes MC. A Systematic Review of Trauma Interventions in Native Communities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 65:223-241. [PMID: 31518009 PMCID: PMC7243818 DOI: 10.1002/ajcp.12396] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
American Indian/Alaska Native and First Nations communities suffer from health disparities associated with multiple forms of trauma exposure. Culturally appropriate interventions are needed to heal current and historical trauma wounds. Although there are evidence-based trauma interventions for other populations, few have been implemented or evaluated with Native communities. Understanding the extant research on trauma interventions in Native communities is crucial for advancing science and filling gaps in the evidence base, and for meeting the needs of underserved people. In this systematic review of the literature on trauma interventions in Native communities in the United States, Canada, Australia, and New Zealand, we identified 15 studies representing 10 interventions for historical and/or current trauma. These studies involved the community to some extent in developing or culturally adapting the interventions and suggested positive outcomes with regard to historical and interpersonal trauma symptoms. However, notable limitations in study design and research methods limit both internal validity and external validity of these conclusions. Only one study attempted (but did not achieve) a quasi-experimental design, and small sample sizes were persistent limitations across studies. Recommendations for researchers include working in partnership with Native communities to overcome barriers to trauma intervention research and to increase the rigor of the studies so that ongoing efforts to treat trauma can yield publishable data and communities can secure funding for intervention research.
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Affiliation(s)
- Julie A Gameon
- Department of Psychology, Montana State University, Bozeman, MT, USA
| | - Monica C Skewes
- Department of Psychology, Montana State University, Bozeman, MT, USA
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Subica AM, Guerrero E, Aitaoto N, Moss HB, Iwamoto D, Wu LT. Hazardous drinking, alcohol use disorders, and need for treatment among Pacific Islander young adults. AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2020; 90:557-566. [PMID: 32352815 PMCID: PMC9048751 DOI: 10.1037/ort0000456] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Pacific Islander (PI) young adults are suspected to bear heavy risk for hazardous drinking, alcohol use disorders (AUD), and alcohol-related harms. Yet, PIs remain among the most understudied racial groups in the United States-creating a lack of empirical data documenting their alcohol use problems and treatment needs. The present study presents the first known data on PI young adults' hazardous drinking, possible AUDs, alcohol-related harms, and treatment needs. Survey data were collected from 156 community-dwelling PI young adults (40% women, age 18-30 years) in 2 large PI communities: Los Angeles County and Northwest Arkansas. We screened participants for alcohol, cigarette, and marijuana use, hazardous drinking, possible AUD, alcohol-related harms, and past-year need for mental health and substance use disorder (SUD) treatment. Logistic regressions examined whether experiencing possible AUD and alcohol-related harms were associated with past-year need for treatment. PI young adults reported 78% lifetime rate of alcohol use with 56% screening positive for hazardous drinking, 49% for any possible AUD, and 40% experiencing significant alcohol-related harm (e.g., health, finances). Yet, just 25% of participants reported past-year need for SUD treatment. Although having possible AUD was not associated with perceived SUD treatment need, experiencing any alcohol-related harm associated with 4.7-13.2 times greater adjusted odds for needing treatment. Therefore, despite having low self-perceived treatment need, PI young adults experience excessive burden of hazardous drinking and alcohol-related harms. Given the profound negative social and health effects of AUDs, culturally grounded interventions should be designed to reduce PI young adults' elevated rates of hazardous drinking and alcohol-related harms. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Andrew M. Subica
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside
| | | | | | - Howard B. Moss
- Department of Social Medicine, Population, and Public Health, School of Medicine, University of California, Riverside
| | - Derek Iwamoto
- Department of Psychology, University of Maryland, College Park
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Nieri T, Ayón C, Yoo M, Webb M. Perceived ethnic discrimination, ethnic-racial socialization, and substance use among ethnic minority adolescents. J Ethn Subst Abuse 2019; 21:70-89. [PMID: 31889478 DOI: 10.1080/15332640.2019.1707141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Perceived discrimination is a significant problem among ethnic minority adolescents and has been consistently linked to negative outcomes, including substance use, although few studies examine this relation with more than one time point. The present study adds to the literature by examining whether ethnic-racial socialization moderates the effects of perceived discrimination at time 1 on recent substance use six months later in a sample of ethnic minority, public high school students in Southern California. The results from analyses of survey data showed that perceived discrimination did not predict the likelihood of the outcomes, and they suggest that discrimination based on attributes other than ethnicity, such as immigration or documentation status, may be operating in the sample. Future research should simultaneously analyze effects of discrimination by type of attribute as well as level (e.g., intragroup, intergroup, and structural). With regard to ethnic-racial socialization in the multivariate models, cultural socialization was negatively related to the likelihood of the outcomes. Preparation for bias was positively related to the likelihood of the outcomes. Promotion of mistrust was not statistically significantly related to the likelihood of the outcomes. Although the socialization variables did not moderate the effect of perceived discrimination, they were clearly related to substance use in multiple ways, suggesting that future research continue to distinguish the effects of socialization by type to better understand how they can be addressed to optimize youth outcomes.
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Affiliation(s)
- Tanya Nieri
- Sociology Department, University of California, Riverside, California
| | - Cecilia Ayón
- School of Public Policy, University of California, Riverside, California
| | - Min Yoo
- Sociology Department, University of California, Riverside, California
| | - Megan Webb
- Sociology Department, University of California, Riverside, California
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Rasmus SM, Charles B, John S, Allen J. With a Spirit that Understands: Reflections on a Long-term Community Science Initiative to End Suicide in Alaska. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:34-45. [PMID: 31343758 PMCID: PMC6750997 DOI: 10.1002/ajcp.12356] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This retrospective analysis of a long-term community-based participatory research (CBPR) process spans over two decades of work with Alaska Native communities. A call to action from Alaska Native leadership to create more effective strategies to prevent and treat youth suicide and alcohol misuse risk initiated a response from university researchers. This CBPR process transformed into a collaborative effort to indigenously drive and develop solutions through research. The People Awakening project started our team on this translational and transformational pathway through community intervention science in the Central Yup'ik region of Alaska. We examine more deeply the major episodes and their successes and struggles in maintaining a long-term research relationship between university researchers and members of Yup'ik Alaska Native communities. We explore ways that our CBPR relationship has involved negotiation and engagement with power and praxis, to deepen and focus attention to knowledge systems and relational elements. This paper examines these deeper, transformative elements of our CBPR relationship that spans histories, cultures, and systems. Our discussion shares vignettes from academic and community perspectives to describe process in a unique collaboration, reaching to sometimes touch upon rare ground in emotions, tensions, and triumphs over the course of a dozen grants and twice as many years. We conclude by noting how there are points where, in a long-term CBPR relationship, transition out of emergence into coalescing and transformation can occur.
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Affiliation(s)
- Stacy M. Rasmus
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, 205 Arctic Health Research Building, 2141 Koyukuk Drive, PO Box 757000, 99775-7000
| | - Billy Charles
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, 205 Arctic Health Research Building, 2141 Koyukuk Drive, PO Box 757000, 99775-7000
| | - Simeon John
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, 205 Arctic Health Research Building, 2141 Koyukuk Drive, PO Box 757000, 99775-7000
| | - James Allen
- Department of Family Medicine and Biobehavioral Health & Memory Keepers Medical Discovery Team - American Indian and Rural Health Equity, University of Minnesota Medical School, Duluth Campus, 624 E. 1st St., Suite 201, Duluth, MN 55805
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Pérez GOG, Constanzo AXZ. [Meanings regarding the development of problematic consumption and alcohol dependence in rural Mapuche communities of the Araucanía region, Chile, 2016-2017]. Salud Colect 2019; 15:e1932. [PMID: 31365692 DOI: 10.18294/sc.2019.1932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 04/24/2019] [Indexed: 11/24/2022] Open
Abstract
This research looks in to the conceptions, meanings and practices involved in the development of problematic consumption and alcohol dependence in rural Mapuche communities in southern Chile in the years 2016-2017. It characterizes the meanings surrounding at-risk consumption as well as scenarios and processes that protect health and those that facilitate risk, and identifies sociocultural elements to potentiate preventive actions. The methodology used was qualitative-ethnographic. Nine in-depth interviews were conducted with adults with at-risk consumption, recovered alcohol users, and non-consumers of alcohol, and ethnographic observations were carried out in participatory workshops with the community. The results link processes of transculturation, loss and cultural vitality with socio-relational dynamics that are at the base of the development of problematic alcohol consumption, marking a scenario of high complexity that requires overcoming the traditional dichotomy of risk/protection factors.
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Affiliation(s)
- Gabriela Orieta Garcés Pérez
- Antropóloga, Magíster en Salud Pública Comunitaria y Desarrollo Local. Docente, Universidad Católica de Temuco, Temuco, Chile.
| | - Alba Ximena Zambrano Constanzo
- Psicóloga, Doctora en Psicología Social. Directora, Departamento de Psicología, Universidad de la Frontera, Temuco, Chile.
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Subica AM, Aitaoto N, Link BG, Yamada AM, Henwood BF, Sullivan G. Mental Health Status, Need, and Unmet Need for Mental Health Services Among U.S. Pacific Islanders. Psychiatr Serv 2019; 70:578-585. [PMID: 30991907 PMCID: PMC6602838 DOI: 10.1176/appi.ps.201800455] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study examined the mental health status, need for services, and unmet need of community-dwelling Native Hawaiian and other Pacific Islanders (NHPI). METHODS Survey data were collected from 223 NHPI adults of Samoan or Marshallese heritage. Surveys were translated into Samoan and Marshallese by using back-translation, with feedback from cultural experts. Severity of depression, anxiety, and alcohol use were measured, as were perceived need for and avoidance of, or delay in, seeking mental health services. Logistic regressions calculated adjusted odds ratios for past-year perceived need for services and avoidance or delay of needed services, controlling for depression, anxiety, and alcohol use. RESULTS Participants' screened prevalence of major depression, generalized anxiety disorder, and alcohol use disorder was 21%, 12%, and 22%, respectively. In the past year, 35% and 26% of participants reported needing services and avoiding or delaying needed services, respectively. Urban Samoan and rural Marshallese participants did not differ significantly in measures of depression, anxiety, or alcohol use, even though the groups had significant demographic differences. Female gender and greater familiarity-contact with persons with mental illness were significant predictors of both reporting service need and reporting avoiding or delaying services. CONCLUSIONS Community-dwelling NHPIs reported a heavy burden of depression, anxiety, and alcohol use, and high perceived need for services, yet low levels of help-seeking. The large unmet need in the sample suggests that a gap may exist between service need and engagement in U.S. NHPI communities that could be targeted with culturally tailored approaches that promote engagement in care.
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Affiliation(s)
- Andrew M. Subica
- University of California, Riverside Center for Healthy Communities, School of Medicine
| | | | - Bruce G. Link
- University of California, Riverside School of Public Policy
| | - Ann Marie Yamada
- University of Southern California, USC Suzanne Dworak-Peck School of Social Work
| | - Benjamin F. Henwood
- University of Southern California, USC Suzanne Dworak-Peck School of Social Work
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Okamoto SK, Helm S, Ostrowski LK, Flood L. The Validation of a School-Based, Culturally Grounded Drug Prevention Curriculum for Rural Hawaiian Youth. Health Promot Pract 2018; 19:369-376. [PMID: 28443350 PMCID: PMC5623612 DOI: 10.1177/1524839917704210] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to validate a school-based, culturally grounded drug prevention curriculum for rural Native Hawaiian youth. Faculty and administrators from eight geographically dispersed middle-, intermediate-, or multilevel schools on Hawai'i island were interviewed on the cultural relevance and feasibility of implementation of the curriculum (Ho'ouna Pono). While all participants appreciated the culturally specific content interwoven throughout the curriculum's structure, several of them expressed concerns that the curriculum would compete with resources needed to implement Common Core national standards. Implications for the implementation, adoption, and sustainability of school-based prevention curricula are discussed.
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Affiliation(s)
| | - Susana Helm
- 2 University of Hawai'i at Mānoa, Honolulu, HI, USA
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Okamoto SK, Kulis S, Helm S, Lauricella M, Valdez JK. An Evaluation of the Ho'ouna Pono Curriculum: A Pilot Study of Culturally Grounded Substance Abuse Prevention for Rural Hawaiian Youth. J Health Care Poor Underserved 2018; 27:815-33. [PMID: 27180710 DOI: 10.1353/hpu.2016.0061] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This pilot study evaluated the Ho'ouna Pono curriculum, which is a culturally grounded, school-based, drug prevention curriculum tailored to rural Native Hawaiian youth. The curriculum focuses on culturally relevant drug resistance skills training and is aligned with the State of Hawai'i academic standards. Six Hawai'i Island public middle/intermediate schools randomly assigned to intervention or treatment-as-usual comparison conditions (N = 213) were evaluated in this study. Paired sample t-tests separating intervention and comparison groups were conducted, as well as mixed models that adjusted for random effects (nesting) at the school level. Findings suggested that the curriculum was effective in maintaining youths' use of culturally relevant drug resistance skills, as well as decreasing girls' aggressive behaviors, at six-month follow-up. Unanticipated findings also suggested areas for curricular improvement, including more emphasis on normative drug education. Implications for future research and development of the curriculum are discussed.
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Donovan DM, Thomas LR, Sigo RLW, Price L, Lonczak H, Lawrence N, Ahvakana K, Austin L, Lawrence A, Price J, Purser A, Bagley L. Healing of the canoe: preliminary results of a culturally tailored intervention to prevent substance abuse and promote tribal identity for Native youth in two Pacific Northwest tribes. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2016; 22:42-76. [PMID: 25768390 DOI: 10.5820/aian.2201.2015.42] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Using Community-based and Tribal Participatory Research (CBPR/TPR) approaches, an academic-tribal partnership between the University of Washington Alcohol and Drug Abuse Institute and the Suquamish and Port Gamble S'Klallam Tribes developed a culturally grounded social skills intervention to promote increased cultural belonging and prevent substance abuse among tribal youth. Participation in the intervention, which used the Canoe Journey as a metaphor for life, was associated with increased hope, optimism, and self-efficacy and with reduced substance use, as well as with higher levels of cultural identity and knowledge about alcohol and drugs among high school-age tribal youth. These results provide preliminary support for the intervention curricula in promoting positive youth development, an optimistic future orientation, and the reduction of substance use among Native youth.
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Lauricella M, Valdez JK, Okamoto SK, Helm S, Zaremba C. Culturally Grounded Prevention for Minority Youth Populations: A Systematic Review of the Literature. J Prim Prev 2016; 37:11-32. [PMID: 26733384 DOI: 10.1007/s10935-015-0414-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Contemporary prevention science has focused on the application of cultural adaptations of evidence-based prevention programs for minority youth populations. Far less is known about culturally grounded methods that are intended to organically develop prevention programs within specific populations and communities. This article systematically reviews recent literature on culturally grounded interventions used to prevent health disparities in ethnic minority youth populations. In this review, we assessed 31 peer-reviewed articles published in 2003 or later that fit inclusionary criteria pertaining to the development and evaluation of culturally grounded prevention programs. The evaluated studies indicated different approaches toward cultural grounding, as well as specific populations, geographic regions, and health issues that have been targeted. Specifically, the findings indicated that most of the studies focused on the development and evaluation of culturally grounded HIV/STI and substance abuse prevention programs for Mexican-American, African American, and American Indian/Alaska Native youth residing in the South or Southwestern US. These studies largely relied on community-based participatory or qualitative research methods to develop programs from the "ground up." This review has implications for the development of future culturally grounded and culturally adapted prevention programs targeting underserved minority youth populations and geographic regions. Specifically, it identifies populations and regions where culturally grounded prevention efforts are underdeveloped or non-existent, providing some scientific direction for the future development of these types of programs.
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Affiliation(s)
| | | | - Scott K Okamoto
- School of Social Work, Hawai'i Pacific University, 45-045 Kamehameha Hwy., NA #3, Kaneohe, HI, 96744, USA.
| | - Susana Helm
- Department of Psychiatry, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Colleen Zaremba
- School of Social Work, Hawai'i Pacific University, 45-045 Kamehameha Hwy., NA #3, Kaneohe, HI, 96744, USA
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Ayón C, Baldwin A, Umaña-Taylor AJ, Marsiglia FF, Harthun M. Agarra el momento/seize the moment: Developing communication activities for a drug prevention intervention with and for Latino families in the US Southwest. QUALITATIVE SOCIAL WORK : QSW : RESEARCH AND PRACTICE 2016; 15:281-299. [PMID: 26924943 PMCID: PMC4764090 DOI: 10.1177/1473325014566487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This article presents the development of parent-child communication activities by applying Community-Based Participatory Research and focus group methodology. Three parent-child communication activities were developed to enhance an already efficacious parenting intervention: (1) agarra el momento or seize the moment uses everyday situations to initiate conversations about substance use, (2) hay que adelantarnos or better sooner than later stresses being proactive about addressing critical issues with youth, and (3) setting rules and expectations engages parents in establishing rules and expectations for healthy and effective conversations with youth. Focus group data are presented to illustrate how thematic content from the focus groups was used to inform the development of the activities and, furthermore, how such methods supported the development of a culturally grounded intervention.
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Affiliation(s)
- Cecilia Ayón
- School of Social Work, Arizona State University, USA
| | | | | | - Flavio F Marsiglia
- Southwest Interdisciplinary Research Center (SIRC); School of Social Work, Arizona State University, USA
| | - Mary Harthun
- Southwest Interdisciplinary Research Center, Arizona State University, USA
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28
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Kim SY, Shen Y, Hou Y, Tilton KE, Juang L, Wang Y. Annual Review of Asian American Psychology, 2014. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2015; 6:291-332. [PMID: 26925199 PMCID: PMC4765738 DOI: 10.1037/aap0000031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This 2014 review of Asian American psychology is the sixth review in the series. It includes 316 articles that met the inclusion criteria established by the past five annual reviews. Featured articles were derived from three sources: 137 were generated via the search term "Asian American" in PyscINFO, 111 were generated via a search for specific Asian American ethnic groups, and 32 were generated via author searches of articles that met the inclusion criteria. The top primary topic was health and health-related behaviors, the most frequently employed study design was cross-sectional, and the most studied Asian American ethnic group was Chinese. This year's review includes information on the target population of the primary topic, the age range and developmental period of participants, and whether the study design was cross-sectional or longitudinal. It also identifies top authors and journals contributing to the 2014 annual review. These new features reveal that the most common target population of the primary topic was youths; studies most commonly included emerging adults ages 18-25; cross-sectional study design was employed more often than longitudinal design; the top contributor to the 2014 review was Stephen Chen, who authored the highest number of papers included; and the Asian American Journal of Psychology generated the highest number of publications for this review.
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Affiliation(s)
- Su Yeong Kim
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 471-5524
| | - Yishan Shen
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 983-7551
| | - Yang Hou
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 660-2236
| | - Kelsey E Tilton
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 956-459-4212
| | - Linda Juang
- University of Potsdam, College of Human Sciences, Education, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany, +49 (0)172 1882255,
| | - Yijie Wang
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 289-8136
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Gewin AM, Hoffman B. Introducing the cultural variables in school-based substance abuse prevention. DRUGS-EDUCATION PREVENTION AND POLICY 2015. [DOI: 10.3109/09687637.2015.1071781] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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A continuum of approaches toward developing culturally focused prevention interventions: from adaptation to grounding. J Prim Prev 2014; 35:103-12. [PMID: 24322970 DOI: 10.1007/s10935-013-0334-z] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purpose of this article is to describe a conceptual model of methods used to develop culturally focused interventions. We describe a continuum of approaches ranging from non-adapted/surface-structure adapted programs to culturally grounded programs, and present recent examples of interventions resulting from the application of each of these approaches. The model has implications for categorizing culturally focused prevention efforts more accurately, and for gauging the time, resources, and level of community engagement necessary to develop programs using each of the different methods. The model also has implications for funding decisions related to the development and evaluation of programs, and for planning of participatory research approaches with community members.
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31
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Wu LT, Blazer DG, Swartz MS, Burchett B, Brady KT. Illicit and nonmedical drug use among Asian Americans, Native Hawaiians/Pacific Islanders, and mixed-race individuals. Drug Alcohol Depend 2013; 133:360-7. [PMID: 23890491 PMCID: PMC3818295 DOI: 10.1016/j.drugalcdep.2013.06.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 06/15/2013] [Accepted: 06/15/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The racial/ethnic composition of the United States is shifting rapidly, with non-Hispanic Asian-Americans, Native Hawaiians/Pacific Islanders (NHs/PIs), and mixed-race individuals the fastest growing segments of the population. We determined new drug use estimates for these rising groups. Prevalences among Whites were included as a comparison. METHODS Data were from the 2005-2011 National Surveys on Drug Use and Health. Substance use among respondents aged ≥ 12 years was assessed by computer-assisted self-interviewing methods. Respondents' self-reported race/ethnicity, age, gender, household income, government assistance, county type, residential stability, major depressive episode, history of being arrested, tobacco use, and alcohol use were examined as correlates. We stratified the analysis by race/ethnicity and used logistic regression to estimate odds of drug use. RESULTS Prevalence of past-year marijuana use among Whites increased from 10.7% in 2005 to 11.6-11.8% in 2009-2011 (P<0.05). There were no significant yearly changes in drug use prevalences among Asian-Americans, NHs/PIs, and mixed-race people; but use of any drug, especially marijuana, was prevalent among NHs/PIs and mixed-race people (21.2% and 23.3%, respectively, in 2011). Compared with Asian-Americans, NHs/PIs had higher odds of marijuana use, and mixed-race individuals had higher odds of using marijuana, cocaine, hallucinogens, stimulants, sedatives, and tranquilizers. Compared with Whites, mixed-race individuals had greater odds of any drug use, mainly marijuana, and NHs/PIs resembled Whites in odds of any drug use. CONCLUSIONS Findings reveal alarmingly prevalent drug use among NHs/PIs and mixed-race people. Research on drug use is needed in these rising populations to inform prevention and treatment efforts.
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Affiliation(s)
- Li-Tzy Wu
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, United States.
| | - Dan G. Blazer
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, United States
| | - Marvin S. Swartz
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, United States
| | - Bruce Burchett
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27710, United States
| | - Kathleen T. Brady
- Clinical Neurosciences Division, Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, United States
| | - NIDA AAPI Workgroup
- National Institute on Drug Abuse Asian American and Pacific Islander Researchers and Scholars Workgroup, Bethesda, MD 20892, United States
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