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Chando S, Howell M, Young C, Craig JC, Eades SJ, Dickson M, Howard K. Outcomes reported in evaluations of programs designed to improve health in Indigenous people. Health Serv Res 2021; 56:1114-1125. [PMID: 33748978 PMCID: PMC8586489 DOI: 10.1111/1475-6773.13653] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To assess the outcomes reported and measured in evaluations of complex health interventions in Indigenous communities. DATA SOURCES We searched all publications indexed in MEDLINE, PreMEDLINE, EMBASE, PsycINFO, EconLit, and CINAHL until January 2020 and reference lists from included papers were hand-searched for additional articles. STUDY DESIGN Systematic review. DATA COLLECTION/EXTRACTION METHODS We included all primary studies, published in peer-reviewed journals, where the main objective was to evaluate a complex health intervention developed specifically for an Indigenous community residing in a high-income country. Only studies published in English were included. Quantitative and qualitative data were extracted and summarized. PRINCIPAL FINDINGS Of the 3523 publications retrieved, 62 evaluation studies were included from Australia, the United States, Canada, and New Zealand. Most studies involved less than 100 participants and were mainly adults. We identified outcomes across 13 domains: clinical, behavioral, process-related, economic, quality of life, knowledge/awareness, social, empowerment, access, environmental, attitude, trust, and community. Evaluations using quantitative methods primarily measured outcomes from the clinical and behavioral domains, while the outcomes reported in the qualitative studies were mostly from the process-related and empowerment domains. CONCLUSION The outcomes from qualitative evaluations, which better reflect the impact of the intervention on participant health, remain different from the outcomes routinely measured in quantitative evaluations. Measuring the outcomes from qualitative evaluations alongside outcomes from quantitative evaluations could result in more relevant evaluations to inform decision making in Indigenous health.
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Affiliation(s)
- Shingisai Chando
- University of SydneySydneyNew South WalesAustralia
- Centre for Kidney ResearchThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | - Martin Howell
- University of SydneySydneyNew South WalesAustralia
- Centre for Kidney ResearchThe Children's Hospital at WestmeadWestmeadNew South WalesAustralia
| | | | - Jonathan C. Craig
- College of Medicine and Public HealthFlinders UniversityAdelaideSouth AustraliaAustralia
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Armenta RF, Kellogg D, Montoya JL, Romero R, Armao S, Calac D, Gaines TL. "There Is a Lot of Practice in Not Thinking about That": Structural, Interpersonal, and Individual-Level Barriers to HIV/STI Prevention among Reservation Based American Indians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3566. [PMID: 33808175 PMCID: PMC8037532 DOI: 10.3390/ijerph18073566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022]
Abstract
American Indians (AI) face significant disparities in HIV/STI morbidity and mortality, and historical, structural, interpersonal, and individual level barriers stymie prevention efforts. The objective of this paper is to examine barriers to HIV/STI prevention among reservation-based AI. We conducted face-to-face qualitative interviews with 17 reservation-based AI community leaders and community members in Southern California on HIV/STI knowledge and attitudes and barriers to prevention. The disruption of traditional coping mechanisms and healing processes were compromised by historical trauma, and this allowed stigmas to exist where they did not exist before. This impacted access to healthcare services and trust in medicine, and is linked to individuals adopting negative coping behaviors that confer risk for HIV/STI transmission (e.g., substance use and sexual behaviors). Most of the participants reported that HIV/STIs were not discussed in their reservation-based communities, and many participants had a misperception of transmission risk. Stigma was also linked to a lack of knowledge and awareness of HIV/STI's. Limited available services, remoteness of communities, perceived lack of privacy, and low cultural competency among providers further hindered the access and use of HIV/STI prevention services. These findings highlight the need to address the historical, structural, and interpersonal factors impacting individual-level behaviors that can increase HIV/STI transmission among reservation-based AIs. Prevention work should build on community strengths to increase HIV/STI knowledge, reduce stigma, and increase access to preventative care while using culturally grounded methodologies.
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Affiliation(s)
- Richard F Armenta
- Department of Kinesiology, California State University, San Marcos, CA 92078, USA
| | - Daniel Kellogg
- School of Public Health, San Diego State University, San Diego, CA 92182, USA;
| | - Jessica L Montoya
- Department of Psychiatry, University of California, La Jolla, San Diego, CA 92093, USA;
| | - Rick Romero
- Southern California Tribal Health Center, San Diego, CA 92539, USA; (R.R.); (S.A.); (D.C.)
| | - Shandiin Armao
- Southern California Tribal Health Center, San Diego, CA 92539, USA; (R.R.); (S.A.); (D.C.)
| | - Daniel Calac
- Southern California Tribal Health Center, San Diego, CA 92539, USA; (R.R.); (S.A.); (D.C.)
| | - Tommi L Gaines
- Division of Infectious Diseases and Global Public Health, Department of Medicine, School of Medicine, University of California, La Jolla, CA 92093, USA;
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Chando S, Tong A, Howell M, Dickson M, Craig JC, DeLacy J, Eades SJ, Howard K. Stakeholder perspectives on the implementation and impact of Indigenous health interventions: A systematic review of qualitative studies. Health Expect 2021; 24:731-743. [PMID: 33729648 PMCID: PMC8235882 DOI: 10.1111/hex.13230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 02/16/2021] [Accepted: 02/22/2021] [Indexed: 11/18/2022] Open
Abstract
Background Evaluations of health interventions for Indigenous peoples rarely report outcomes that reflect participant and community perspectives of their experiences. Inclusion of such data may provide a fuller picture of the impact of health programmes and improve the usefulness of evaluation assessments. Aim To describe stakeholder perspectives and experiences of the implementation and impact of Indigenous health programmes. Methods We conducted a systematic review of qualitative studies evaluating complex health interventions designed for Indigenous communities in high‐income countries. We searched 6 electronic databases (through to January 2020): MEDLINE, PreMEDLINE, Embase, PsycINFO, EconLit and CINAHL and hand‐searched reference lists of relevant articles. Results From 28 studies involving 677 stakeholders (mostly clinical staff and participants), six main themes were identified: enabling engagement, regaining control of health, improving social health and belonging, preserving community and culture, cultivating hope for a better life, and threats to long‐term programme viability. Conclusion The prominence of social, emotional and spiritual well‐being as important aspects of the health journey for participants in this review highlights the need to reframe evaluations of health programmes implemented in Indigenous communities away from assessments that focus on commonly used biomedical measures. Evaluators, in consultation with the community, should consistently assess the capacity of health professionals to meet community needs and expectations throughout the life of the programme. Evaluations that include qualitative data on participant and community‐level outcomes can improve decision‐makers' understanding of the impact that health programmes have on communities. Patient or public contribution This paper is a review of evaluation studies and did not involve patients or the public.
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Affiliation(s)
- Shingisai Chando
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Allison Tong
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Martin Howell
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | - Michelle Dickson
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan C Craig
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
| | - Jack DeLacy
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia.,Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, NSW, Australia
| | | | - Kirsten Howard
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
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Kenyon DB, McMahon TR, Simonson A, Green-Maximo C, Schwab A, Huff M, Sieving RE. My Journey: Development and Practice-Based Evidence of a Culturally Attuned Teen Pregnancy Prevention Program for Native Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030470. [PMID: 30736271 PMCID: PMC6388191 DOI: 10.3390/ijerph16030470] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 01/29/2019] [Accepted: 02/01/2019] [Indexed: 11/16/2022]
Abstract
A clear need exists for teen pregnancy prevention programs that are responsive to the specific needs and cultural contexts of Native American communities. Recent data indicates that the birth rate for Native teens is nearly two and a half times the rate for White teens (32.9 versus 13.2). To address this disparity, we conducted formative research with Northern Plains Native American community members, resulting in My Journey, a culturally attuned curriculum for 6–8th graders. My Journey is grounded in traditional values and teachings to promote self-efficacy in sexual health decision-making and engagement in prosocial behaviors. We conducted a pilot study with 6–8th grade students (n = 45), aged 11–14 years (22 females, 23 males). Pilot study findings confirm program feasibility and acceptability. The process evaluation revealed that teachers liked the curriculum, particularly its adaptability of cultural components and ease of student engagement. The outcome evaluation demonstrated that My Journey provided an avenue for NA youth to increase their sex refusal self-efficacy. Application of the culture cube framework revealed My Journey has made a meaningful practice-based evidence contribution as a community-defined, culturally integrated curriculum that is effective. Future directions include broader implementation of My Journey, including adaption for additional populations.
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Affiliation(s)
- DenYelle Baete Kenyon
- Behavioral Sciences, Sanford Research, Sioux Falls, SD 57104, USA.
- Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, SD 57105, USA.
| | - Tracey R McMahon
- Behavioral Sciences, Sanford Research, Sioux Falls, SD 57104, USA.
| | - Anna Simonson
- Behavioral Sciences, Sanford Research, Sioux Falls, SD 57104, USA.
| | | | - Ashley Schwab
- Marketing, Sanford Health, Sioux Falls, SD 57104, USA.
| | - Melissa Huff
- Sisseton-Wahpeton Oyate Tribal Health Administration, Agency Village, SD 57262, USA.
| | - Renee E Sieving
- School of Nursing & Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA.
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Liddell J, Burnette CE. Culturally-Informed Interventions for Substance Abuse Among Indigenous Youth in the United States: A Review. ACTA ACUST UNITED AC 2017. [PMID: 28628397 DOI: 10.1080/23761407.2017.1335631] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Given the disproportionately high levels of alcohol and other drug abuse among Indigenous youth in the United States, the purpose of this systematic review was to explicate the current state of empirically-based and culturally-informed substance abuse prevention and intervention programs for Indigenous youth (ages 9-18). METHOD The 14 articles that met inclusion criteria for this review were analyzed both in terms of the cultural intervention itself (primary population, intervention, core tenants, focus of intervention, intervention goals, location, intervention location, and program length) and their evaluation approach. RESULTS Results indicate variable integration of cultural components with the majority of interventions taking place in schools and treatment facilities, targeting primarily individuals. DISCUSSION There is a current gap in research on culturally-informed substance abuse interventions for Indigenous youth, which this review begins to address. Promising areas of future research and interventions include bringing communities and families into treatment and prevention.
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Affiliation(s)
- Jessica Liddell
- a School of Social Work , Tulane University , New Orleans , Louisiana , USA
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Jacobs-Wingo JL, Espey DK, Groom AV, Phillips LE, Haverkamp DS, Stanley SL. Causes and Disparities in Death Rates Among Urban American Indian and Alaska Native Populations, 1999-2009. Am J Public Health 2016; 106:906-14. [PMID: 26890168 PMCID: PMC4985112 DOI: 10.2105/ajph.2015.303033] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2015] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To characterize the leading causes of death for the urban American Indian/Alaska Native (AI/AN) population and compare with urban White and rural AI/AN populations. METHODS We linked Indian Health Service patient registration records with the National Death Index to reduce racial misclassification in death certificate data. We calculated age-adjusted urban AI/AN death rates for the period 1999-2009 and compared those with corresponding urban White and rural AI/AN death rates. RESULTS The top-5 leading causes of death among urban AI/AN persons were heart disease, cancer, unintentional injury, diabetes, and chronic liver disease and cirrhosis. Compared with urban White persons, urban AI/AN persons experienced significantly higher death rates for all top-5 leading causes. The largest disparities were for diabetes and chronic liver disease and cirrhosis. In general, urban and rural AI/AN persons had the same leading causes of death, although urban AI/AN persons had lower death rates for most conditions. CONCLUSIONS Urban AI/AN persons experience significant disparities in death rates compared with their White counterparts. Public health and clinical interventions should target urban AI/AN persons to address behaviors and conditions contributing to health disparities.
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Affiliation(s)
- Jasmine L Jacobs-Wingo
- Jasmine L. Jacobs-Wingo, at the time of the study, was with the Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. David K. Espey is with the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Amy V. Groom is with the Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Leslie E. Phillips, at the time of the study, was with the Urban Indian Health Institute, Seattle, WA. Donald S. Haverkamp is with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. At the time of study, Sandte L. Stanley was with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
| | - David K Espey
- Jasmine L. Jacobs-Wingo, at the time of the study, was with the Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. David K. Espey is with the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Amy V. Groom is with the Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Leslie E. Phillips, at the time of the study, was with the Urban Indian Health Institute, Seattle, WA. Donald S. Haverkamp is with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. At the time of study, Sandte L. Stanley was with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
| | - Amy V Groom
- Jasmine L. Jacobs-Wingo, at the time of the study, was with the Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. David K. Espey is with the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Amy V. Groom is with the Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Leslie E. Phillips, at the time of the study, was with the Urban Indian Health Institute, Seattle, WA. Donald S. Haverkamp is with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. At the time of study, Sandte L. Stanley was with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
| | - Leslie E Phillips
- Jasmine L. Jacobs-Wingo, at the time of the study, was with the Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. David K. Espey is with the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Amy V. Groom is with the Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Leslie E. Phillips, at the time of the study, was with the Urban Indian Health Institute, Seattle, WA. Donald S. Haverkamp is with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. At the time of study, Sandte L. Stanley was with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
| | - Donald S Haverkamp
- Jasmine L. Jacobs-Wingo, at the time of the study, was with the Office for State, Tribal, Local and Territorial Support, Centers for Disease Control and Prevention, Atlanta, GA. David K. Espey is with the National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. Amy V. Groom is with the Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention. Leslie E. Phillips, at the time of the study, was with the Urban Indian Health Institute, Seattle, WA. Donald S. Haverkamp is with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. At the time of study, Sandte L. Stanley was with the Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention
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Tingey L, Mullany B, Chambers R, Hastings R, Barlow A, Rompalo A. The Respecting the Circle of Life trial for American Indian adolescents: rationale, design, methods, and baseline characteristics. AIDS Care 2015; 27:885-91. [PMID: 25714127 DOI: 10.1080/09540121.2015.1015481] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This paper describes the rationale, design, methods, and baseline results of a randomized controlled trial to evaluate the impact of an adapted evidence-based intervention (EBI), "Respecting the Circle of Life" (RCL) to reduce behavioral risks for HIV/AIDS among American Indian (AI) adolescents. A participatory approach shaped intervention adaptation and study design. A total of 267 participants (aged 13-19) were randomized by peer groups of the same sex to receive the RCL intervention or a control condition. Self-report assessments were administered at four intervals. The sample was predominately female (57%), had low HIV knowledge prevention scores, early sexual initiation (mean 14.6 years), and 56% reported intention to use a condom at next sex. Baseline characteristics were evenly distributed between groups with the exception of age and extrinsic reward scores. This is the first rigorous evaluation of an adapted EBI for HIV/AIDS prevention among AI adolescents, an at-risk and understudied population.
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Affiliation(s)
- Lauren Tingey
- a Department of International Health, Johns Hopkins Center for American Indian Health , Johns Hopkins University Bloomberg School of Public Health , Baltimore , MD , USA
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Salam RA, Haroon S, Ahmed HH, Das JK, Bhutta ZA. Impact of community-based interventions on HIV knowledge, attitudes, and transmission. Infect Dis Poverty 2014; 3:26. [PMID: 25126420 PMCID: PMC4132935 DOI: 10.1186/2049-9957-3-26] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 06/30/2014] [Indexed: 11/10/2022] Open
Abstract
In 2012, an estimated 35.3 million people lived with HIV, while approximately two million new HIV infections were reported. Community-based interventions (CBIs) for the prevention and control of HIV allow increased access and ease availability of medical care to population at risk, or already infected with, HIV. This paper evaluates the impact of CBIs on HIV knowledge, attitudes, and transmission. We included 39 studies on educational activities, counseling sessions, home visits, mentoring, women's groups, peer leadership, and street outreach activities in community settings that aimed to increase awareness on HIV/AIDS risk factors and ensure treatment adherence. Our review findings suggest that CBIs to increase HIV awareness and risk reduction are effective in improving knowledge, attitudes, and practice outcomes as evidenced by the increased knowledge scores for HIV/AIDS (SMD: 0.66, 95% CI: 0.25, 1.07), protected sexual encounters (RR: 1.19, 95% CI: 1.13, 1.25), condom use (SMD: 0.96, 95% CI: 0.03, 1.58), and decreased frequency of sexual intercourse (RR: 0.76, 95% CI: 0.61, 0.96). Analysis shows that CBIs did not have any significant impact on scores for self-efficacy and communication. We found very limited evidence on community-based management for HIV infected population and prevention of mother- to-child transmission (MTCT) for HIV-infected pregnant women. Qualitative synthesis suggests that establishment of community support at the onset of HIV prevention programs leads to community acceptance and engagement. School-based delivery of HIV prevention education and contraceptive distribution have also been advocated as potential strategies to target high-risk youth group. Future studies should focus on evaluating the effectiveness of community delivery platforms for prevention of MTCT, and various emerging models of care to improve morbidity and mortality outcomes.
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Affiliation(s)
- Rehana A Salam
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Sarah Haroon
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Hashim H Ahmed
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jai K Das
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Zulfiqar A Bhutta
- Center of Excellence in Women & Child Health, The Aga Khan University, Karachi, Pakistan
- Center for Global Child Health Hospital for Sick Children, Toronto, Canada
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Saftner MA, Martyn KK, Momper SL, Loveland-Cherry CJ, Low LK. Urban American Indian Adolescent Girls: Framing Sexual Risk Behavior. J Transcult Nurs 2014; 26:365-75. [PMID: 24803532 DOI: 10.1177/1043659614524789] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The purpose of this study was to explore factors that influence urban adolescent American Indian (AI) girls' sexual risk behavior. DESIGN A qualitative study was conducted with grounded theory methodology to reveal factors and processes that influence sexual risk behavior. METHOD Talking circles, individual interviews, and event history calendars were used with 20 urban AI 15- to 19-year-old girls to explore influences on sexual risk behavior. RESULTS The generated theory-framing sexual risk behavior-describes social and structural factors and processes that influenced the girls' sexual risk behavior. The theory extends Bronfenbrenner's ecological model by identifying microsystem, mesosystem, and macrosystem influences on sexual risk behavior. DISCUSSION Urban AI girls reported similar social and structural influences on sexual risk behavior as urban adolescents from other racial and ethnic groups. However, differences were noted in the family structure, cultural heritage, and unique history of AIs. IMPLICATIONS This theory can be used in culturally responsive practice with urban AI girls.
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Affiliation(s)
| | - Kristy K Martyn
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
| | - Sandra L Momper
- University of Michigan School of Social Work, Ann Arbor, MI, USA
| | | | - Lisa Kane Low
- University of Michigan School of Nursing, Ann Arbor, MI, USA
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Whitbeck LB, Walls ML, Welch ML. Substance abuse prevention in American Indian and Alaska Native communities. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2013; 38:428-35. [PMID: 22931077 DOI: 10.3109/00952990.2012.695416] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In this article we review three categories of American Indian/Alaska Native (AIAN) substance abuse prevention programs: (1) published empirical trials; (2) promising programs published and unpublished that are in the process of development and that have the potential for empirical trials; and (3) examples of innovative grassroots programs that originate at the local level and may have promise for further development. AIAN communities are taking more and more independent control of substance abuse prevention. We point out that European American prevention scientists are largely unaware of the numerous grassroots prevention work going on in AIAN communities and urge a paradigm shift from adapting European American prevention science "best practices" to creating cultural "best practices" by working from inside AIAN communities.
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Affiliation(s)
- Les B Whitbeck
- Department of Sociology, University of Nebraska-Lincoln , Lincoln, NE , USA.
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