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Garcia AN, Empey A, Bell S. Addressing the Impacts of Racism on American Indian and Alaska Native Child Health. Acad Pediatr 2024; 24:S126-S131. [PMID: 39428143 DOI: 10.1016/j.acap.2023.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 10/22/2024]
Abstract
The legacy of racism toward Native Americans is far-reaching. We will review the topic using the conceptual model of racism as a form of violence as it is inherent in racism, as are prejudice and power. Using the basic frameworks of racism as internalized, interpersonal, institutional, and structural, we will discuss the many types of racism affecting Native Americans today. Racism is the bedrock of generations of trauma experienced in Native communities. The generational/historical trauma of racism has led to epigenetic-level changes affecting Native American people today. We will cover the health impacts of racism and the many institutions built in racist frameworks that continue to perpetuate racism, such as family separation and child removal by child protective services, adverse policing, and disparate incarceration. These allow reflection on policies and the intentionality of racist structures. We will conclude with what can and should be done, particularly as clinicians who work within and adjacent to existing systems of oppression.
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Affiliation(s)
- Andrea N Garcia
- Los Angeles County Department of Mental Health (AN Garcia), Mandan, Hidatsa, Arikara.
| | - Allison Empey
- Department of Pediatrics, Oregon Health & Science University (A Empey), Confederated Tribes of Grand Ronde
| | - Shaquita Bell
- Department of Pediatrics, and Seattle Children's Hospital (S Bell), University of Washington School of Medicine, Cherokee
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Kulis SS, Tsethlikai M, Ayers SL, Gresenz KE. Parenting in 2 Worlds: Testing improved parent-adolescent communication about sexuality in Urban American Indian families. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024; 34:56-68. [PMID: 37957746 PMCID: PMC10926230 DOI: 10.1111/jora.12900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
Urban American Indian (AI) adolescents are more likely than non-Natives to have early sexual debut, teen pregnancies, sexually transmitted infections, and inadequate sexual health information. A RCT in three Arizona cities, with 585 parents of urban AI adolescents, tested whether a culturally tailored parenting intervention for urban AI families, Parenting in 2 Worlds (P2W), increased parent-adolescent communication about sexuality, compared to an informational family health intervention that was not culturally tailored. P2W produced significantly larger increases on two measures: communication about general sexual health and about sexual decision-making. The desired effects of P2W on the first measure were stronger short-term for cross-gender dyads, while for the second measure, they were stronger long-term for both mothers and fathers of adolescent sons.
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Affiliation(s)
- Stephen S. Kulis
- School of Social and Family Dynamics, Arizona State
University
- Global Center for Applied Health Research, Arizona State
University
| | | | | | - Kyle E. Gresenz
- School of Social and Family Dynamics, Arizona State
University
- Global Center for Applied Health Research, Arizona State
University
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Asdigian NL, Tuitt N, Mousseau AC, Ivanich JD, Schultz K, Keane EM, Zacher T, Skinner L, Richards FRW, Robe LB, Whitesell NR. Grounding evidence-based prevention within cultural context: promising effects of substance use prevention adapted for American Indian families. Subst Use Misuse 2023; 58:1004-1013. [PMID: 37125477 PMCID: PMC10259753 DOI: 10.1080/10826084.2023.2201847] [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: 05/02/2023]
Abstract
Background: Effective substance use prevention strategies are needed for American Indian (AI) youth, who face disproportionate risk for early substance use and consequently bear a disproportionate burden of health and developmental disparities related to early use. With few exceptions, significant advances in prevention science have largely excluded this population, leaving gaps in the evidence of effective practice. This paper builds on emerging efforts to address this gap, reporting first outcome findings from an evidence-based early substance use prevention program culturally adapted for young adolescents on a Northern Plains reservation. Methods: Using a community-based participatory approach, the Thiwáhe Gluwáš'akapi Program (TG, sacred home in which family is made strong) was developed by embedding cultural kinship teachings within the Strengthening Families Program for Parents and Youth 10-14 and aligning other elements of program content with local culture and context. Results: Results of pre and post comparisons of proximal program outcomes showed that youth reported significant improvements in parental communication about substance use, substance use resistance skills, stress management, family cohesion, and overall well-being. Adults reported improvements in a wide array of parenting behaviors and indicators of family dynamics. Conclusions: These findings provide an initial glimpse into the potential effects of the TG program and suggest that it holds promise for helping AI families address risks for youth substance use through positive impacts on modifiable risk and protective factors documented to influence early substance use.
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Affiliation(s)
- Nancy L. Asdigian
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, MS F800, 13055 E. 17 Avenue, Aurora, CO, 80045
| | - Nicole Tuitt
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, MS F800, 13055 E. 17 Avenue, Aurora, CO, 80045
| | | | - Jerreed D. Ivanich
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, MS F800, 13055 E. 17 Avenue, Aurora, CO, 80045
| | - Katie Schultz
- School of Social Work, University of Michigan, 1080 S. University Ave, Ann Arbor, MI 48103
| | - Ellen M. Keane
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, MS F800, 13055 E. 17 Avenue, Aurora, CO, 80045
| | - Tracy Zacher
- Missouri Breaks Industries Research, Inc., 2309 School Road, Manderson, SD 57756, USA
| | - Leslie Skinner
- Missouri Breaks Industries Research, Inc., 2309 School Road, Manderson, SD 57756, USA
| | | | - Lisa Bear Robe
- Missouri Breaks Industries Research, Inc., 2309 School Road, Manderson, SD 57756, 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. 17 Avenue, Aurora, CO, 80045
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