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Kjerland TM, Schroeder S, Tofaeono V. Increased community engagement of Indigenous Peoples in dementia research leads to higher context relevance of results. DEMENTIA 2024; 23:643-668. [PMID: 38445447 PMCID: PMC11059836 DOI: 10.1177/14713012241233651] [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] [Indexed: 03/07/2024]
Abstract
INTRODUCTION Health research that focuses on Indigenous Peoples must ensure that the community in question is actively engaged, and that the results have context relevance for Indigenous Peoples. Context relevance is "the benefits, usability, and respectful conduct of research from the perspective of Indigenous communities." The purpose of this study was to apply two tools within an already-published scoping review of 76 articles featuring research on cognitive impairment and dementia among Indigenous Peoples worldwide. One tool assessed levels of community engagement reported in the corpus, and the other tool assessed the context relevance of recommendations in the corpus. We hypothesized that research with higher levels of reported community engagement would produce recommendations with greater context relevance for Indigenous Peoples. METHODS We employed semi-structured deductive coding using two novel tools assessing levels of reported community engagement and context relevance of recommendations based on studies included in the existing scoping review. RESULTS Application of the two tools revealed a positive relationship between increasing community engagement and greater context relevance. Community engagement primarily occurred in studies conducted with First Nations, Inuit, and Métis populations in Canada and with Australian Aboriginal and/or Torres Strait Islander Peoples. Research with Alaska Native, American Indian, and Native Hawaiian Peoples in the USA stood out for its comparative lack of meaningful community engagement. DISCUSSION There is opportunity to utilize these tools, and the results of this assessment, to enhance training and mentorship for researchers who work with Indigenous populations. There is a need to increase investigator capacity to involve communities throughout all phases of research, particularly in the pre-research stages.
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Affiliation(s)
- Tonya M Kjerland
- Department of Indigenous Health, University of North Dakota, USA
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Edinoff AN, Maudrie TL, Chiwiwi C, Kjerland TM, Contreras L, Gone JP. A complex psychosocial portrait of substance use disorders among Indigenous people in the United States: A scoping review. Am J Addict 2024. [PMID: 38591758 DOI: 10.1111/ajad.13539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 02/19/2024] [Accepted: 03/13/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND AND OBJECTIVES There has been a prevailing but erroneous belief in the medical community that there is a biological vulnerability in the American Indian/Alaskan Native (AI/AN) community to substance use disorders (SUDs), with alcohol use disorder (AUD) being the most prevalent. This scoping review aimed to examine what possible psychosocial issues could lead to the development of the perpetuation of SUDs in the AI/AN population. METHODS The protocol for this scoping review followed Arksey and O'Malley's methodological framework. There were 405 articles included for full-text review. Further inclusion criteria were applied which included: Directly looking at participants who had a SUD, including either in the discussion or conclusion a statement linking their data to psychosocial issues as a possible explanation for their data, and having measured the psychosocial issue with a research device. The final review included 15 studies. RESULTS Four psychosocial themes were uncovered using an inductive process, where recurring words related to identity, prejudice, isolation, discrimination, and self-concept in the literature. These themes were trauma/historical loss, mood, and discrimination/self-esteem. All of these themes are interrelated, and all influence the development or sustainment of a SUD. DISCUSSION AND CONCLUSIONS Complex psychosocial factors in the AI/AN community are associated with SUDs. This trauma and historical loss should be addressed with culturally tailored treatments. SCIENTIFIC SIGNIFICANCE There are not many manuscripts that specifically look at the interplay of mood, trauma, self-worth, and discrimination with SUD in the AI/AN community. This scoping review aims to highlight these issues as well as discuss how culture should play a part in treatment.
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Affiliation(s)
- Amber N Edinoff
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
- Division of Alcohol, Drugs, and Addiction, McLean Hospital, Belmont, Massachusetts, USA
| | - Tara L Maudrie
- Department of International Health, Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carly Chiwiwi
- Contra Costa Health, Department of Family and Community Medicine, Martinez, California, USA
| | - Tonya M Kjerland
- Department of Indigenous Health, University of North Dakota, Grand Forks, North Dakota, USA
| | - Liz Contreras
- Harvard Graduate School of Education, Cambridge, Massachusetts, USA
| | - Joseph P Gone
- Department of Anthropology, Harvard University, Cambridge, Massachusetts, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
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Held S, Feng D, McCormick A, Schure M, Other Medicine L, Hallett J, Inouye J, Allen S, Holder S, Bull Shows B, Trottier C, Kyro A, Kropp S, Turns Plenty N. The Báa nnilah Program: Results of a Chronic-Illness Self-Management Cluster Randomized Trial with the Apsáalooke Nation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:285. [PMID: 38541285 PMCID: PMC10970069 DOI: 10.3390/ijerph21030285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 04/05/2024]
Abstract
Indigenous people in Montana are disproportionately affected by chronic illness (CI), a legacy of settler colonialism. Existing programs addressing CI self-management are not appropriate because they are not consonant with Indigenous cultures in general and the Apsáalooke culture specifically. A research partnership between the Apsáalooke (Crow Nation) non-profit organization Messengers for Health and Montana State University co-developed, implemented, and evaluated a CI self-management program for community members. This article examines qualitative and quantitative program impacts using a pragmatic cluster randomized clinical trial design with intervention and waitlist control arms. The quantitative and qualitative data resulted in different stories on the impact of the Báa nnilah program. Neither of the quantitative hypotheses were supported with one exception. The qualitative data showed substantial positive outcomes across multiple areas. We examine why the data sets led to two very different stories, and provide study strengths and limitations, recommendations, and future directions.
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Affiliation(s)
- Suzanne Held
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Du Feng
- Department of Nursing, University of Nevada, Las Vegas, NV 89154, USA;
| | - Alma McCormick
- Messengers for Health, Crow Agency, MT 59022, USA; (A.M.); (L.O.M.)
| | - Mark Schure
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | | | - John Hallett
- Petaluma Health Center, Petaluma, CA 94954, USA;
| | - Jillian Inouye
- Manoa School of Nursing, University of Hawaii, Honolulu, HI 96822, USA;
| | - Sarah Allen
- Department of Family Life & Human Development, Southern Utah University, Cedar City, UT 84720, USA;
| | - Shannon Holder
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Brianna Bull Shows
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Coleen Trottier
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Alexi Kyro
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
| | - Samantha Kropp
- Department of Human Development & Community Health, Montana State University, Bozeman, MT 59717, USA; (M.S.); (S.H.); (B.B.S.); (C.T.); (A.K.); (S.K.)
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Barry CM, Livingston MD, Livingston BJ, Kominsky TK, Komro KA. School Racial Composition as a Moderator of the Effect of Discrimination on Mental Health and Substance use Among American Indian Adolescents. J Adolesc Health 2024; 74:44-50. [PMID: 37737758 PMCID: PMC10926889 DOI: 10.1016/j.jadohealth.2023.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/15/2023] [Accepted: 07/13/2023] [Indexed: 09/23/2023]
Abstract
PURPOSE To examine the relationships between individual-level perceived racial/ethnic discrimination and mental health and substance use outcomes by school-level racial composition among American Indian (AI) adolescents. METHOD Self-reported survey data on individual-level variables come from a sample of AI adolescents (n = 510) living in or near the Cherokee Nation during the fall of 2021. School-level data come from publicly available databases. Multilevel linear and logistic regression analyses were performed to test for and examine the interaction between perceived racial/ethnic discrimination and school racial composition in relation to symptoms of anxiety and depression, past 30-day use of alcohol and marijuana, and misuse of prescription opioids. RESULTS Adjusted analyses showed a significant interaction effect between discrimination and racial composition on anxiety symptoms, such that the effect of discrimination was more pronounced at lower % AI (10th percentile) than at more equivalently mixed (50th percentile) or higher % AI (90th percentile) school settings. No significant interactions were observed with depressive symptoms or substance use outcomes. DISCUSSION School racial compositions of higher percentage AI may buffer the adverse effect of racial/ethnic discrimination on anxiety symptoms among AI adolescents.
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Affiliation(s)
- Caroline M Barry
- Department of Behavioral, Social and Health Education Sciences, Emory University, Rollins School of Public Health, Atlanta, Georgia.
| | - Melvin D Livingston
- Department of Behavioral, Social and Health Education Sciences, Emory University, Rollins School of Public Health, Atlanta, Georgia
| | - Bethany J Livingston
- Department of Behavioral, Social and Health Education Sciences, Emory University, Rollins School of Public Health, Atlanta, Georgia
| | | | - Kelli A Komro
- Department of Behavioral, Social and Health Education Sciences, Emory University, Rollins School of Public Health, Atlanta, Georgia
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Gartner DR, Maples C, Nash M, Howard-Bobiwash H. Misracialization of Indigenous people in population health and mortality studies: a scoping review to establish promising practices. Epidemiol Rev 2023; 45:63-81. [PMID: 37022309 DOI: 10.1093/epirev/mxad001] [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: 07/01/2022] [Revised: 02/27/2023] [Accepted: 04/03/2023] [Indexed: 04/07/2023] Open
Abstract
Indigenous people are often misracialized as other racial or ethnic identities in population health research. This misclassification leads to underestimation of Indigenous-specific mortality and health metrics, and subsequently, inadequate resource allocation. In recognition of this problem, investigators around the world have devised analytic methods to address racial misclassification of Indigenous people. We carried out a scoping review based on searches in PubMed, Web of Science, and the Native Health Database for empirical studies published after 2000 that include Indigenous-specific estimates of health or mortality and that take analytic steps to rectify racial misclassification of Indigenous people. We then considered the weaknesses and strengths of implemented analytic approaches, with a focus on methods used in the US context. To do this, we extracted information from 97 articles and compared the analytic approaches used. The most common approach to address Indigenous misclassification is to use data linkage; other methods include geographic restriction to areas where misclassification is less common, exclusion of some subgroups, imputation, aggregation, and electronic health record abstraction. We identified 4 primary limitations of these approaches: (1) combining data sources that use inconsistent processes and/or sources of race and ethnicity information; (2) conflating race, ethnicity, and nationality; (3) applying insufficient algorithms to bridge, impute, or link race and ethnicity information; and (4) assuming the hyperlocality of Indigenous people. Although there is no perfect solution to the issue of Indigenous misclassification in population-based studies, a review of this literature provided information on promising practices to consider.
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Affiliation(s)
- Danielle R Gartner
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, United States
| | - Ceco Maples
- Department of Anthropology, College of Social Science, Michigan State University, East Lansing, MI 48824, United States
| | - Madeline Nash
- Department of Sociology, College of Social Science, Michigan State University, East Lansing, MI 48824, United States
| | - Heather Howard-Bobiwash
- Department of Anthropology, College of Social Science, Michigan State University, East Lansing, MI 48824, United States
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Haakenstad MK, Butcher MB, Noonan CJ, Fyfe-Johnson AL. Outdoor Time in Childhood: A Mixed Methods Approach to Identify Barriers and Opportunities for Intervention in a Racially and Ethnically Mixed Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7149. [PMID: 38131701 PMCID: PMC10743276 DOI: 10.3390/ijerph20247149] [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: 09/25/2023] [Revised: 10/25/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
A growing body of literature suggests that outdoor time is beneficial for physical and mental health in childhood. Profound disparities exist in access to outdoor spaces (and the health benefits thereof) for children in communities of color. The objectives of this research were to: (1) identify challenges and solutions to outdoor time for children; (2) assess the importance of outdoor time for children; and (3) evaluate results stratified by race/ethnicity. Using a convergent mixed methods approach, we conducted a thematic analysis from 14 focus groups (n = 50) with outdoor educators, parents with children attending outdoor preschools, and community members with children. In addition, 49 participants completed a survey to identify challenges and solutions, perceived importance, and culturally relevant perspectives of outdoor time. The main challenges identified for outdoor time were safety concerns, inclement weather, lack of access to outdoor spaces, and parent work schedules. The primary proposed solution was integrating outdoor time into the school day. Nearly all participants, independent of racial identity, reported that outdoor time improved physical and mental health. Overall outdoor time was lower in participants from communities of color (~8 h/week) compared to their White counterparts (~10 h/week). While 50% of people of color (POC) reported that outdoor time was an important cultural value, only 18% reported that people in their respective culture spent time outside. This work contributes to accumulating knowledge that unique barriers to outdoor time exist for communities of color, and the children that live, learn, and play in these communities. Increasing outdoor time in school settings offers a potential solution to reduce identified barriers and to promote health equity in childhood.
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Affiliation(s)
- Magdalena K. Haakenstad
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Maria B. Butcher
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99202, USA;
| | - Carolyn J. Noonan
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Amber L. Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
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McNeish D. Psychometric properties of sum scores and factor scores differ even when their correlation is 0.98: A response to Widaman and Revelle. Behav Res Methods 2023; 55:4269-4290. [PMID: 36394821 DOI: 10.3758/s13428-022-02016-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 11/18/2022]
Abstract
Commentary in Widaman and Revelle (2022) argued that sum scoring is justified as long as unidimensionality holds because sum score reliability is defined. My response begins with a review of the literature supporting the perspective we adopted in the original article. I then conduct simulation studies to assess the psychometric properties of sum scores created using Widaman and Revelle's justification relative to scores created by the weighted factor score approach in the original article. In my simulations, I generate data where sum and factor scores are correlated at 0.96 or 0.98 because high factor-sum score correlations are often used to support the contention that sum and factor scores have interchangeable psychometric properties. I explore (a) correlations between estimated scores and true scores, (b) classification accuracy of sum and factor scores, and (c) reliability of sum and factor scores. Results show that factor scores have (a) higher correlations with true scores (Δ = 0.02-0.04), (b) higher sensitivity (Δ = 4-8 percentage points), and (c) higher reliability (Δ = 0.04-0.07). Factor score performance metrics also have less sampling variability in most conditions. Psychometric properties of sum scores-even when highly correlated with factor scores-remain less desirable than those of factor scores. Additional considerations like models with multiple factors and measurement invariance are also discussed. Essentially, even if accepting Widaman and Revelle's justification for sum scoring, it is uncertain whether researchers generally would want to sum score after fitting a factor analysis unless sum and factor scores correlate at (and not merely close to) 1.00.
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Affiliation(s)
- Daniel McNeish
- Department of Psychology, Arizona State University, PO Box 871104, Tempe, AZ, 85287, USA.
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Merculief A, Lipscomb S, McClelland MM, Geldhof GJ, Tsethlikai M. Nurturing resilience in American Indian/Alaska Native preschool children: the role of cultural socialization, executive function, and neighborhood risk. Front Psychol 2023; 14:1279336. [PMID: 38098526 PMCID: PMC10719932 DOI: 10.3389/fpsyg.2023.1279336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/10/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction American Indian and Alaska Native (AI/AN) children possess numerous cultural assets, yet higher exposures to neighborhood risks (e.g., lack of housing, crime) may present barriers to healthy cognitive development, including executive function (EF). Cultural socialization may promote resilience and support children's early cognition, but this has not been adequately studied. The present study examined the effects of neighborhood risk and cultural socialization on EF for AI/AN preschool children. Method Parents/caregivers of 768 AI/AN preschoolers from the 2015 AI/AN Head Start Family and Community Experiences (FACES) Study rated neighborhood risk via two scales: "Neighborhood Problems" and "Environmental Conditions," and cultural socialization practices via two scales: cultural activities and tribal language activities. Children's EF was measured directly using the Pencil Tap Task and the Leiter-R attention subscale. Results Families perceived neighborhood risks as relatively low, and overall risk did not predict children's EF. However, higher average language socialization was significantly related to higher EF, as were two specific language activities (encouraging children to learn their tribal language, making sure children heard their tribal language) and two cultural activities (playing AI/AN games, participating in tribal ceremonies), controlling for neighborhood risk. Discussion Findings suggest some aspects of cultural socialization may promote resilience among AI/AN preschoolers by supporting early EF. Mechanisms may include increased spiritual, social, and cultural connections, and practice with EF skills during cultural games. Future research should partner with AI/AN communities to investigate culturally grounded EF interventions and reevaluate measures of neighborhood risk to promote resilience and connectedness for AI/AN children.
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Affiliation(s)
- Alexis Merculief
- Human Development and Family Studies, Oregon State University, Corvallis, OR, United States
| | - Shannon Lipscomb
- Human Development and Family Studies, Oregon State University, Corvallis, OR, United States
| | - Megan M. McClelland
- Human Development and Family Studies, Oregon State University, Corvallis, OR, United States
| | - G. John Geldhof
- Human Development and Family Studies, Oregon State University, Corvallis, OR, United States
| | - Monica Tsethlikai
- Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, United States
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Douglass MA, Crabtree MA, Stanley LR, Swaim RC, Prince MA. Family ties: examining family functioning and alcohol use among American Indian youth. DRUGS, HABITS AND SOCIAL POLICY 2023; 24:372-387. [PMID: 38654708 PMCID: PMC11034930 DOI: 10.1108/dhs-06-2023-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Purpose This study aims to examine a second-order latent variable of family functioning built from two established protective factors for American Indian (AI) youth, i.e. family cohesion and parental monitoring. This study then examines if family functioning is related to alcohol use frequency or age of initiation for AI youth. Additionally, this study examines if family functioning served as a moderator for the risk factor of peer alcohol use. Design/methodology/approach Data came from the 2021 Our Youth, Our Future survey. Participants were 4,373 AI adolescents from Grades 6-12 across the contiguous USA. Structural equation modeling (SEM) was used to test the latent variable of family functioning. Structural paths and interaction terms between peer use and family functioning were added to the SEM to explore direct and moderating effects. Findings Family cohesion and parental monitoring were best represented by a second-order latent variable of family functioning, which was related to later initiation and lower alcohol use frequency. Practical implications The findings regarding the initiation of alcohol use may be applicable to prevention programs, with family functioning serving as a protective factor for the initiation of alcohol use. Programs working toward alcohol prevention may be best served by focusing on family-based programs. Originality/value The latent variable of family functioning is appropriate for use in AI samples. Family functioning, which is an inherent resilience factor in AI communities, was shown to be protective against harmful alcohol use behaviors.
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Affiliation(s)
- Morgan A Douglass
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Meghan A Crabtree
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Linda R Stanley
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Randall C Swaim
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Mark A Prince
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
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Crouch MC, Venner KL, Wendt DC, Burlew AK, Baukol P, Funaro MC, Sorrell T, Haeny AM. Lessons learned and future directions: A scoping review of American Indian and Alaska Native participants in the National Drug Abuse Treatment Clinical Trials Network. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 153:209081. [PMID: 37230391 PMCID: PMC10529616 DOI: 10.1016/j.josat.2023.209081] [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: 06/30/2022] [Revised: 02/09/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION American Indian and Alaska Native (AI/AN) populations are disproportionately affected by substance use disorders (SUDs) and related health disparities in contrast to other ethnoracial groups in the United States. Over the past 20 years, substantial resources have been allocated to the National Institute on Drug Abuse Clinical Trials Network (CTN) to disseminate and implement effective SUD treatments in communities. However, we know little about how these resources have benefitted AI/AN peoples with SUD who arguably experience the greatest burden of SUDs. This review aims to determine lessons learned about AI/AN substance use and treatment outcomes in the CTN and the role of racism and Tribal identity. METHOD We conducted a scoping review informed by the Joanna Briggs framework and PRISMA Extension for Scoping Reviews checklist and explanation. The study team conducted the search strategy within the CTN Dissemination Library and nine additional databases for articles published between 2000 and 2021. The review included studies if they reported results for AI/AN participants. Two reviewers determined study eligibility. RESULTS A systematic search yielded 13 empirical articles and six conceptual articles. Themes from the 13 empirical articles included: (1) Tribal Identity: Race, Culture, and Discrimination; (2) Treatment Engagement: Access and Retention; (3) Comorbid Conditions; (4) HIV/Risky Sexual Behaviors; and (5) Dissemination. The most salient theme was Tribal Identity: Race, Culture, and Discrimination, which was present in all articles that included a primary AI/AN sample (k = 8). Themes assessed but not identified for AI/AN peoples were Harm Reduction, Measurement Equivalence, Pharmacotherapy, and Substance Use Outcomes. The conceptual contributions used AI/AN CTN studies as exemplars of community-based and Tribal participatory research (CBPR/TPR). CONCLUSION CTN studies conducted with AI/AN communities demonstrate culturally congruent methods, including CBPR/TPR strategies; consideration/assessment of cultural identity, racism, and discrimination; and CBPR/TPR informed dissemination plans. Although important efforts are underway to increase AI/AN participation in the CTN, future research would benefit from strategies to increase participation of this population. Such strategies include reporting AI/AN subgroup data; addressing issues of cultural identity and experiences of racism; and adopting an overall effort for research aimed at understanding barriers to treatment access, engagement, utilization, retention, and outcomes for both treatment and research disparities for AI/AN populations.
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Affiliation(s)
- Maria C Crouch
- Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
| | - Kamilla L Venner
- University of New Mexico, 1 University of New Mexico, MSC03 2220, Albuquerque, NM 87131-0001, United States
| | - Dennis C Wendt
- McGill University, 3700 McTavish St., Room 614, Montreal, QC H3A 1Y2, Canada
| | - Ann Kathleen Burlew
- University of Cincinnati, 2600 Clifton Ave., Cincinnati, OH 45220, United States
| | - Paulette Baukol
- Berman Center for Outcomes & Clinical Research, 701 Park Ave., Suite PP7.700, Minneapolis, MN 55415, United States
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, 333 Cedar St, New Haven, CT 06510, United States
| | - Tanya Sorrell
- Rush University Medical Center, 1645 W Jackson Blvd, Westgate Building, Suite 600, Chicago, IL 60612, United States
| | - Angela M Haeny
- Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States
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Nguyen CJ, French BF, Maudrie TL, Ferguson GL, Blue Bird Jernigan V, Sinclair KIA. Measuring Food Security among American Indian and Alaska Native Adults: Validity Evidence Supports the Use of the US Department of Agriculture Module. J Acad Nutr Diet 2023; 123:S76-S88. [PMID: 37730308 DOI: 10.1016/j.jand.2023.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 02/17/2023] [Accepted: 02/28/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Inequities in access, availability, and affordability of nutritious foods produced by settler colonialism contribute to high rates of food insecurity among American Indian and Alaska Native (AI/AN) households. Efforts to understand the influences of food security programming among AI/AN individuals in the United States are constrained by the absence of validity evidence for food security assessments for this population. OBJECTIVE This study assessed whether AI/AN adult responses on the Food Security Survey Module provide an accurate assessment of food security prevalence, especially when compared with other racial and ethnic groups. DESIGN A correlational design with the cross-sectional 2019 National Health Interview Survey was used to address the research objective. PARTICIPANTS AND SETTING The 2019 National Health Interview Survey contains a sample (N = 30,052) representative of the resident civilian noninstitutionalized population. MAIN OUTCOME MEASURES The primary outcome was food security, as characterized by the 10-item US Department of Agriculture Adult Food Security Survey Module. The module evaluates whether insufficient finances result in perceived food shortages and a reduction in the quantity and/or quality of food intake during the prior 30 days. STATISTICAL ANALYSES PERFORMED Data were analyzed by racial and ethnic subsamples to assess scale dimensionality (confirmatory factor analysis), Item Response Theory item analysis, differential item functioning, and external validity (χ2 tests). RESULTS Results supported the use of the 10-item module for racial and ethnic groups. However, differential item functioning effect sizes exceeded criteria for the Asian, AI/AN, and Hispanic respondents when compared with White respondents. Food security was not significantly related to all expected correlates in the AI/AN subsample. CONCLUSIONS Compelling evidence is presented for validity of the FSSM scores in determining food security status of AI/AN adults. Qualitative inquiry that explores how culture influences the way food security is conceptualized and experienced is warranted.
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Affiliation(s)
- Cassandra J Nguyen
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington; Elson S. Floyd College of Medicine, Washington State University, Seattle, Washington.
| | - Brian F French
- College of Education, Washington State University, Pullman, Washington
| | - Tara L Maudrie
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Gary L Ferguson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington
| | - Valarie Blue Bird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma
| | - Ka Imi A Sinclair
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, Washington; College of Nursing, Washington State University, Seattle, Washington
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Harry ML, Sanchez K, Ahmedani BK, Beck AL, Coleman KJ, Coley RY, Daida YG, Lynch FL, Rossom RC, Waring SC, Simon GE. Assessing the differential item functioning of PHQ-9 items for diverse racial and ethnic adults with mental health and/or substance use disorder diagnoses: A retrospective cohort study. J Affect Disord 2023; 338:402-413. [PMID: 37127116 PMCID: PMC10524453 DOI: 10.1016/j.jad.2023.04.091] [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] [Received: 01/30/2023] [Revised: 04/07/2023] [Accepted: 04/24/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Improving health equity in depression care and suicide screening requires that measures like the Patient Health Questionnaire 9 (PHQ-9) function similarly for diverse racial and ethnic groups. We evaluated PHQ-9 differential item functioning (DIF) between racial/ethnic groups in a retrospective cohort study of secondary electronic health record (EHR) data from eight healthcare systems. METHODS The population (n = 755,156) included patients aged 18-64 with mental health and/or substance use disorder (SUD) diagnoses who had a PHQ-9 with no missing item data in the EHR for primary care or mental health visits between 1/1/2009-9/30/2017. We drew two random samples of 1000 from the following racial/ethnic groups originally recorded in EHRs (n = 14,000): Hispanic, and non-Hispanic White, Black, Asian, American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander, multiracial. We assessed DIF using iterative hybrid ordinal logistic regression and item response theory with p < 0.01 and 1000 Monte Carlo simulations, where change in model R2 > 0.01 represented non-negligible (e.g., clinically meaningful) DIF. RESULTS All PHQ-9 items displayed statistically significant, but negligible (e.g., clinically unmeaningful) DIF between compared groups. The negligible DIF varied between random samples, although six items showed negligible DIF between the same comparison groups in both random samples. LIMITATIONS Our findings may not generalize to disaggregated racial/ethnic groups or persons without mental health and/or SUD diagnoses. CONCLUSIONS We found the PHQ-9 had clinically unmeaningful cross-cultural DIF for adult patients with mental health and/or SUD diagnoses. Future research could disaggregate race/ethnicity to discern if within-group identification impacts PHQ-9 DIF.
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Affiliation(s)
- Melissa L Harry
- Essentia Health, Essentia Institute of Rural Health, Duluth, MN, USA.
| | - Katherine Sanchez
- Baylor Scott and White, Center for Applied Health Research, Temple, TX, USA
| | - Brian K Ahmedani
- Henry Ford Health, Center for Health Policy & Health Services Research, Detroit, MI, USA
| | - Arne L Beck
- The Kaiser Permanente Colorado Institute for Health Research, Aurora, CO, USA
| | - Karen J Coleman
- Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, CA, USA
| | - R Yates Coley
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Yihe G Daida
- Kaiser Permanente Hawaii, Center for Integrated Health Care Research, Honolulu, HI, USA
| | - Frances L Lynch
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | | | - Stephen C Waring
- Essentia Health, Essentia Institute of Rural Health, Duluth, MN, USA
| | - Gregory E Simon
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
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Tuitt N, Asdigian NL, Mousseau A, Ivanich J, Zacher T, Skinner L, Red Willow Richards F, Bear Robe L, Keane E, Boland S, Whitesell NR. Measure of Socialization of American Indian Children (MOSAIC): Understanding the roots of ethnic-racial identity. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2023; 29:564-574. [PMID: 36154056 PMCID: PMC10039960 DOI: 10.1037/cdp0000559] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVES The Measure of Socialization of American Indian Children (MOSAIC) was created as part of a larger study developing a family-based and culturally grounded substance use prevention program for young American Indian (AI) adolescents. The MOSAIC was designed to measure ethnic-racial socialization (ERS) for use with AI families to support better understanding of the roots of ethnic-racial identity among AI youth and their relationship to risk for substance use in early adolescence. METHOD This study was conducted in partnership with a Lakota reservation community. Community partners and advisors provided guidance on the creation of an item pool, which also drew extensively from the existing literature on ERS in other populations. The MOSAIC was pilot tested with a small sample of parents (N = 19) and then tested with a development sample of participants (N = 197) taking part in the larger study. A series of factor analyses were conducted with data from this development sample to explore associations among items and alignment with proposed dimensions. RESULTS Four dimensions emerged, related to socialization practices to support spirituality, language, pride, and preparation for bias. The original MOSIAC measure was refined based on these analyses and prepared for testing in an independent sample. CONCLUSIONS Dimensions of ERS common to measures developed for other populations emerged as relevant for AI families, with adaptations to reflect the unique context of this population. Further work is needed to confirm the structure of the MOSAIC in both this AI community and with other diverse indigenous populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Nicole Tuitt
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
| | - Nancy L. Asdigian
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
| | | | - Jerreed Ivanich
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
| | | | | | | | | | - Ellen Keane
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
| | - Sarah Boland
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus
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14
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Edwards KM, Waterman EA, Mullet N, Herrington R, Cornelius S, Hopfauf S, Trujillo P, Wheeler LA, Deusch AR. Indigenous Cultural Identity Protects Against Intergenerational Transmission of ACEs Among Indigenous Caregivers and Their Children. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01795-z. [PMID: 37697145 DOI: 10.1007/s40615-023-01795-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/13/2023]
Abstract
A large body of empirical research has demonstrated that caregiver adverse childhood experiences (ACEs) predict ACEs in one's child, a phenomenon known as the intergenerational transmission of ACEs. Little of this empirical research, however, has focused specifically on Indigenous peoples despite a growing body of theoretical literature and the wisdom of Elders and Traditional Knowledge Keepers that speaks to the presence of this phenomenon within Indigenous communities as well as the protective role of Indigenous cultural identity in preventing the intergenerational transmission of ACEs. The purpose of the current study was to conduct an empirical evaluation of this hypothesis, specifically that Indigenous cultural identity and social support protects against the intergenerational transmission of ACEs among Indigenous peoples and their children in the USA. Participants were 106 Indigenous women caregivers of children ages 10 to 14 in South Dakota who completed surveys. Results showed that Indigenous cultural identity moderated the association between caregiver ACEs and child ACEs. At high levels of cultural identity, there was no association between caregiver ACEs and child ACEs. At low levels of Indigenous cultural identity, however, there was a strong and positive relationship between caregiver ACEs and child ACEs. Social support did not moderate the association between caregiver ACEs and child ACEs. These findings underscore the need for initiatives that enhance Indigenous cultural identity and social support among Indigenous caregivers to prevent the intergenerational transmission of ACEs.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Arielle R Deusch
- Avera Research Institute, Sioux Falls, USA
- University of South Dakota, Vermillion, USA
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15
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Russette HC, Graham N, Swanson S, Semmens EO. Relationship-building to develop an Indigenous community-based epidemiological study investigating developmental resilience factors among children with prenatal substance exposure. J Ethn Subst Abuse 2023; 22:589-605. [PMID: 34469277 PMCID: PMC8885795 DOI: 10.1080/15332640.2021.1965933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Tribal Nations experience substance misuse at high rates often attributed to historical and contemporary traumas. In response, several Tribal Nations are addressing these issues through efforts to promote recovery and prevention to substance misuse. Study objectives were to partner with a Tribal Nation to develop a study to explore factors that contribute to the wellbeing of families to children with prenatal substance exposure and disseminate findings that can be translated back into the community. We applied Community-based participatory research (CBPR), strengths-based, and community-driven approaches during this two-year study development phase. We experienced challenges and identified solutions to partnering with one Tribal Nation on an epidemiological mixed-methods study centered on families with children that have prenatal substance exposure. Key inputs were becoming familiarizing with the community setting, structural supports for CBPR research, incorporating Indigenous CBPR principles, and developing a Community Advisory Team. We successfully collaborated with the Confederated Salish Kootenai Tribes Early Childhood Services program to develop a robust study design and a dissemination plan to ensure translation of study findings to the community. The robust study design consisted of common themes specific to a highly stigmatized study population, substance-abusing pregnant women, to protect participant confidentiality. Research alignment with community goals, allotting meaningful time to develop a research partnership, and incorporating culturally sensitive and community-relevant measures contributed to the successful development of an effective and rigorous study to better serve the Tribal Nation on addressing substance misuse.
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Affiliation(s)
- H. C. Russette
- School of Public and Community Health Sciences, University of Montana, Missoula, U. S A
| | - N. Graham
- American Indian/Alaskan Native Clinical Translational Research Program, Montana State University, Bozeman, U. S A
| | - S. Swanson
- St. Luke Community Healthcare, Ronan, U. S A
| | - E. O. Semmens
- School of Public and Community Health Sciences, University of Montana, Missoula, U. S A
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16
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Pavlov RO, Andreescu V. Gender-based differences in abstention and desistance from drug use among American Indian adolescents. J Ethn Subst Abuse 2023:1-39. [PMID: 36877014 DOI: 10.1080/15332640.2023.2185335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
Informed by the social control theoretical perspective, this study intends to identify the factors more likely to differentiate American Indian (AI) adolescents who never used illicit drugs (abstainers) and those who used drugs in the past but did not report recent drug usage (desisters) from their peers who reported lifetime and recent drug usage (persisters). This secondary analysis is based on data from a multi-site study conducted between 2009 and 2013. It is based on a gender-balanced sample (N = 3,380) of AI adolescents (50.50% male; Mean age = 14.75; SD = 1.69) representing the major AI languages and cultural groups in the U.S. Half of the AI adolescents reported lifetime drug use (50.40%), 37.50% never used drugs, and 12.10% stopped using drugs. When controlling for the variables included in the analysis, AI boys were significantly more likely than AI girls to desist from drug use. Both boys and girls who never used drugs tended to be younger, were less likely to have delinquent friends and a lower level of self-control, had stronger bonds to school, but lower levels of family attachment, and reported increased parental supervision. Compared to drug users, desisters associated significantly less with delinquent peers. While school attachment, self-control, and parental monitoring did not differentiate female desisters from female drug users, adolescent boys who desisted from drug use were more likely to report higher levels of school attachment and parental monitoring and their level of self-control was less likely to be low.
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Affiliation(s)
- Ruben O Pavlov
- Department of Criminal Justice, University of Louisville, Louisville, Kentucky
| | - Viviana Andreescu
- Department of Criminal Justice, University of Louisville, Louisville, Kentucky
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17
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Scott BG, Sunchild L, Small C, McCullen JR. Anxiety and Depression in Northern Plains American Indian Youth: Evidence for Resilience and Risk. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022:1-13. [PMID: 36206519 PMCID: PMC10079783 DOI: 10.1080/15374416.2022.2127101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Developing research collaborations with Indigenous communities to understand the expression and experience of anxiety and depression in American Indian (AI) youth and identifying protective and risk factors may be an important first step toward addressing AI health inequities. We used a community-based participatory research (CBPR) approach to investigate anxiety and depressive disorder symptoms among AI youth living on a Northern Plains reservation. Moreover, we examined whether symptoms were related to two potential protective and risk factors, anxiety control beliefs and rumination. Our tribal research team collected multi-reporter survey data from 71 AI 3rd-6th graders (8-13-years-old; 62.3% female) attending a tribal school, their caregivers, and teachers. Results pointed toward resilience in this sample with 7.3% and 8.7% of AI youth reporting clinical levels of anxiety and depressive disorder symptoms, respectively, and on average experiencing symptoms "Sometimes." There were moderate correlations between youth- and teacher-reported anxiety and depressive disorder symptoms, but no correlation with caregivers. Anxiety control beliefs were lower in older compared to younger AI youth and negatively related to youth-reported anxiety and depressive disorder symptoms, while rumination was positively related to youth-reported anxiety and depressive disorder symptoms and teacher-reported anxiety disorder symptoms. Age moderated relations between anxiety control beliefs and both youth-reported anxiety and depressive disorder symptoms with only significant relations found for older youth. Our findings are consistent with research showing resilience to internalizing problems in AI youth living on a reservation, but replication of their relations to anxiety control beliefs and rumination in other Indigenous peoples is warranted.
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18
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Gonzalez MB, Sittner KJ, Walls ML. Cultural efficacy as a novel component of understanding linkages between culture and mental health in Indigenous communities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:191-201. [PMID: 35285956 PMCID: PMC9452443 DOI: 10.1002/ajcp.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 05/22/2023]
Abstract
We used a novel measure of cultural efficacy to examine empirical pathways between enculturation, efficacy, and two wellbeing outcomes. Cultural factors are not consistently linked to better wellbeing in the academic literature despite widespread understanding of these processes in Indigenous communities. Healing pathways is a community-based participatory study with eight reservations/reserves in the upper Midwest and Canada. This study uses data collected in 2017-2018 (n = 453, 58.1% women, mean age = 26.3 years) and structural equation modeling to test the relationships between enculturation, cultural efficacy, and mental health. The direct effect of enculturation on anxiety was positive. The indirect effect of enculturation via cultural efficacy was negatively associated with anxiety and positively associated with positive mental health. Cultural efficacy is an important linking variable through which the protective effects of culture manifest. The complex nature of culture must be met with innovative measures and deep understanding of Indigenous peoples to fully capture the protective role of culture.
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Affiliation(s)
- Miigis B. Gonzalez
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes HubDuluthMinnesotaUSA
| | - Kelley J. Sittner
- Department of SociologyOklahoma State UniversityStillwaterOklahomaUSA
| | - Melissa L. Walls
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes HubDuluthMinnesotaUSA
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19
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Magarati M, Chambers RS, Yenokyan G, Rosenstock S, Walls M, Slimp A, Larzelere F, Lee A, Pinal L, Tingey L. Predictors of STD Screening From the Indigenist Stress-Coping Model Among Native Adults With Binge Substance Use. Front Public Health 2022; 10:829539. [PMID: 36033733 PMCID: PMC9411734 DOI: 10.3389/fpubh.2022.829539] [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: 12/05/2021] [Accepted: 06/02/2022] [Indexed: 01/21/2023] Open
Abstract
Objective The American Indian/Alaska Native (AI/AN) population in the U.S. is thriving in spite of settler colonialist efforts of erasure. AI/AN people, however, continue to experience persistent health disparities including a disproportionate burden of substance use and sexually transmitted diseases/infections (STDs/STIs), as well as a disproportionate lack of public health STD screening services and STD prevention interventions grounded in AI/AN social contexts, experiences, and epistemologies. The present study explored how stressors and protective factors based on the Indigenist Stress Coping framework predict STD screening outcomes among Native adults. Methods We analyzed baseline self-report data from 254 Native adults ages 18-55 years with recent binge substance use who were enrolled in an evaluation of "EMPWR," a two-session STD risk reduction program in a rural, reservation-based community in the U.S. Southwest. Logistic regression models with robust variance were used to estimate odds ratios of lifetime STD testing for the theoretical stressors and cultural buffers. Results A little over half the sample were males (52.5%, n = 136), with a mean age of 33.6 years (SD = 8.8). The majority (76.7%, n = 195) reported having ever been screened for STD in their life. Discrimination score were significantly associated with lifetime STD testing: The higher discrimination was associated with lower odds of STD testing in the fully adjusted model (aOR = 0.40, 95%CI: 0.18, 0.92). The effects of AI/AN-specific cultural buffer such as participation in traditional practices on STD testing outcomes was in the expected positive direction, even though the association was not statistically significant. Household size was significantly associated with STD screening: The higher the number of people lived together in the house, the higher the odds of STD testing in the fully adjusted model (aOR = 1.19, 95%CI: 1.04, 1.38). Conclusion Our findings suggest that STD prevention programs should take into consideration AI/AN-specific historical traumatic stressors such as lifetime discrimination encounters and how these interact to drive or discourage sexual health services at local clinics. In addition, larger household size may be a protective factor functioning as a form of social support, and the extended family's role should be taken into consideration. Future research should consider improvement in measurements of AI/AN enculturation constructs.
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Affiliation(s)
- Maya Magarati
- Seven Directions, A Center for Indigenous Public Health, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States,*Correspondence: Maya Magarati
| | - Rachel Strom Chambers
- Department of International Health, Johns Hopkins Center for American Indian Health, Whiteriver, AZ, United States
| | - Gayane Yenokyan
- Johns Hopkins Biostatistics Center, Baltimore, MD, United States
| | - Summer Rosenstock
- Department of International Health, Johns Hopkins Center for American Indian Health, Whiteriver, AZ, United States
| | - Melissa Walls
- Department of International Health, John Hopkins Center for American Indian Health, Great Lakes Hub, Duluth, MN, United States
| | - Anna Slimp
- Department of International Health, Johns Hopkins Center for American Indian Health, Whiteriver, AZ, United States
| | - Francene Larzelere
- Department of International Health, Johns Hopkins Center for American Indian Health, Whiteriver, AZ, United States
| | - Angelita Lee
- Department of International Health, Johns Hopkins Center for American Indian Health, Whiteriver, AZ, United States
| | - Laura Pinal
- Department of International Health, Johns Hopkins Center for American Indian Health, Whiteriver, AZ, United States
| | - Lauren Tingey
- Department of International Health, Johns Hopkins Center for American Indian Health, Whiteriver, AZ, United States
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20
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Brooks JL, Knafl GJ, Adams LB, Woods-Giscombé CL, Berry DC, Currin EG, Corbie-Smith GM. Methodological Considerations in Scale Refinement with Diverse Populations: A Case Example Using the CES-D with a Community Sample of American Indian Women. Issues Ment Health Nurs 2022; 43:776-783. [PMID: 35344449 PMCID: PMC9375584 DOI: 10.1080/01612840.2022.2053012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Although many psychometric assessments are used extensively in population-based research to determine psychopathology, these tools have not been thoroughly validated or appropriately adapted for use in diverse populations. Indeed, depression measurement studies among American Indian and female populations are scarce, omitting key opportunities to tailor psychological measurement for this population. To build psychometric evidence of measures in this population, we used a procedural method to examine a standard psychological instrument-the Center for Epidemiological Studies Depression Scale (CES-D)-with a community sample of southeast American Indian women. Our results showed strong psychometric reliability of the 20-item CES-D. The "effort" item presented diminished validity, as demonstrated by a negative counter-intuitive item-to-total correlation (ITC) value. Dropping the "effort" item resulted in a 19-item scale with a better fit in the within-group examination of community-based American Indian women. Compared to the 20-item CES-D scale, the revised 19-item measure ("effort" item removed) resulted in minimal changes to women's depression categories. However, we did detect patterns in shifts such that the 19-item scale generally underestimated (i.e., placed women in a lower category) depressive symptoms compared to the 20-item scale. Depending on their study goals, researchers engaging in population-based research should carefully weigh the use of original scales that allow for consistency in reporting with refined scales that fit psychometrically. We present the outlined method as a tool that expands on current approaches in scale refinement, and aids researchers in making more informed decisions regarding refined scales with diverse populations.
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Affiliation(s)
- Jada L Brooks
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - George J Knafl
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Leslie B Adams
- Department of Mental Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Cheryl L Woods-Giscombé
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Diane C Berry
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily G Currin
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Giselle M Corbie-Smith
- Department of Social Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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21
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Kelley A, McCoy T, Skye M, Singer M, Craig Rushing S, Perkins T, Donald C, Rajani K, Morgan B, Milligan K, Zaback T, Lambert W. Psychometric evaluation of protective measures in Native STAND: A multi-site cross-sectional study of American Indian Alaska Native high school students. PLoS One 2022; 17:e0268510. [PMID: 35580116 PMCID: PMC9113605 DOI: 10.1371/journal.pone.0268510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 05/03/2022] [Indexed: 11/18/2022] Open
Abstract
American Indian and Alaska Native (AI/AN) youth are strong in culture and rich in heritage and experience unique strengths and challenges throughout adolescence. Documenting conditions that protect against risk factors associated with poor health outcomes are needed. We explored scales that measure self-esteem, culture, social support, and community from a sample of 1,456 youth involved in Native STAND, a culturally-relevant evidence-based sexual health intervention. We established content validity by reviewing existing literature and community feedback. Construct validity was examined using factor analysis. The final self-esteem model included seven items, factor loadings ranged from 0.47 to 0.63 for positive self-esteem and 0.77 to 0.81 for negative self-esteem. The final culture model included three items, factor loadings 0.73 to 0.89. The social support scale included four items, factor loadings ranged from 0.86 to 0.87 for family social support and 0.75 to 0.77 for friends social support. The community and community safety scale included three items; factor loadings ranged from 0.52 to 0.82. Coefficient alphas for scales ranged from α = 0.63 to α = 0.86. This study validated scales in a national sample of AI/AN youth-psychometric scales provide an essential tool for documenting the needs and strengths of AI/AN youth.
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Affiliation(s)
- Allyson Kelley
- Allyson Kelley and Associates, Sisters, Oregon, United States of America
| | - Thomas McCoy
- School of Nursing, University of North Carolina Greensboro, Greensboro, North Carolina, United States of America
| | - Megan Skye
- Obstetrics and Gynecology, Section of Family Planning, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Michelle Singer
- Northwest Portland Area Indian Health Board, Portland, Oregon, United States of America
| | | | - Tamara Perkins
- NPC Research, Portland, Oregon, United States of America
| | - Caitlin Donald
- Obstetrics and Gynecology, Section of Family Planning, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Kavita Rajani
- Obstetrics and Gynecology, Section of Family Planning, Oregon Health and Science University, Portland, Oregon, United States of America
| | - Brittany Morgan
- Department of Public Health Sciences, University of California Davis, Davis, California, United States of America
| | - Kelley Milligan
- Allyson Kelley and Associates, Sisters, Oregon, United States of America
| | - Tosha Zaback
- Obstetrics and Gynecology, Section of Family Planning, Oregon Health and Science University, Portland, Oregon, United States of America
| | - William Lambert
- Obstetrics and Gynecology, Section of Family Planning, Oregon Health and Science University, Portland, Oregon, United States of America
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Yamane CYEW, Helm S. Indigenous Culture-as-Health: A Systematized Literature Review. JOURNAL OF PREVENTION (2022) 2022; 43:167-190. [PMID: 35286545 DOI: 10.1007/s10935-022-00666-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
This paper has two goals regarding cultural rigor, defined as privileging cultural ways of knowing and being as a means to achieving health and well-being for future generations. First, we move the continuum of health practices beyond cultural grounding to include Indigenous Culture-as-Health. Second, this project expands the concept of Indigenous Culture-as-Health in addiction and recovery to include a broader range of health, inclusive of prevention, to further understand this emerging model. Our review of the literature yielded an expanded cultural continuum that includes Indigenous Culture-as-Health, which appears to rely on four modalities: 1) Indigenous ways of knowing, 2) Indigenous cultural practices, 3) place-based/sacred sites, and 4) Indigenous spirituality. For Indigenous health, standards are defined by centuries of ancestral consciousness among Indigenous people across generations, in spite of settler-colonial systems that do not serve them. In other words, Indigenous Culture-as-Health practices contribute to self-determination, sovereignty, and liberation. Incorporating these strategies also will ameliorate other problems related to White supremacy and health, such as epistemic exploitation. Additional implications for prevention practice and policy are described.
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Affiliation(s)
- Cherry Y E W Yamane
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai`i at Mānoa, Honolulu, HI, USA.
| | - Susana Helm
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai`i at Mānoa, Honolulu, HI, USA
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Haroz EE, Ivanich JD, Barlow A, O’Keefe VM, Walls M, Kaytoggy C, Suttle R, Goklish N, Cwik M. Balancing cultural specificity and generalizability: Brief qualitative methods for selecting, adapting, and developing measures for research with American Indian communities. Psychol Assess 2022; 34:311-319. [PMID: 34941353 PMCID: PMC9124435 DOI: 10.1037/pas0001092] [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] [Indexed: 11/08/2022]
Abstract
Culturally appropriate, valid and reliable measures are critical to assessing how interventions impact health. There is a tension between measures for specific cultural settings versus more general measures that permit comparisons across samples. We illustrate a feasible approach to measurement selection, adaptation and testing for a study of brief interventions to prevent suicide among American Indian youth ages 10-24. We used a modified Nominal Group Technique (NGT) with N = 7 Apache Community Mental Health Specialists (CMHS') to elicit priority impacts of interventions under study. We then tested the reliability and validity in N = 93 youth at baseline. The NGT results included selection of alternative measures, item removal and addition, and creation of a local well-being index. Measurement testing indicated excellent to good internal consistency (α: 0.82-0.96) and strong construct validity. Study results demonstrate a feasible approach to balancing cultural specificity and generalizability while producing valid and reliable measures to use in an intervention trial. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Emily E. Haroz
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - Jerreed D. Ivanich
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health
| | - Allison Barlow
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - Victoria M. O’Keefe
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - Melissa Walls
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - Cindy Kaytoggy
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - Rose Suttle
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - Novalene Goklish
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health
| | - Mary Cwik
- Center for American Indian Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health
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Sarche M, Malone LM, Hoard L, Barnes‐Najor J, Cameron A, West J, Barofsky M. Perspectives of Region XI Head Start Federal, Research, and Program Partners in Carrying out a National Study of American Indian and Alaska Native Head Start Children, Families, and Programs. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 69:239-253. [PMID: 34423438 PMCID: PMC9290477 DOI: 10.1002/ajcp.12542] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The American Indian and Alaska Native Head Start Family and Child Experiences Survey (AIAN FACES) 2015 was the first national study of children served by Region XI Head Start programs, which are those operated by federally recognized AIAN tribes. Until 2015, Region XI programs had not been included in national studies of Head Start children's experiences and development, leaving them without this critical source of data to inform policy and practice as is available to other Head Start regions. To address this gap, four groups of stakeholders gathered to plan for a study that put the needs of Region XI Head Start at the forefront, was informed by the historical context of research with AIAN communities, and was guided by community psychology and community-based and tribal participatory approaches. Engaged partnership is a common practice in research with AIAN communities, but rarely on a national scale across diverse communities. The study's success speaks to the success of the unique national partnership between the Region XI Head Start, research, and federal stakeholders who formed the AIAN FACES Workgroup. This first-person account documents the perspective of each group as they undertook this seminal effort and reviews connections with, and lessons learned for, the broader field of community psychology.
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Affiliation(s)
- Michelle Sarche
- Colorado School of Public Health, Centers for American Indian and Alaska Native HealthUniversity of Colorado Anschutz Medical CampusAuroraCOUSA
| | | | - Laura Hoard
- Office of Planning, Research, and EvaluationAdministration for Children and FamiliesWashingtonDCUSA
| | - Jessica Barnes‐Najor
- University Outreach and Engagement, Office for Public Engagement and ScholarshipMichigan State UniversityEast LansingMIUSA
| | - Ann Cameron
- Inter‐Tribal Council of MichiganSault Ste. MarieMIUSA
| | | | - Meryl Barofsky
- Office of Planning, Research, and EvaluationAdministration for Children and FamiliesWashingtonDCUSA
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Kim J, Li L, Korous KM, Valiente C, Tsethlikai M. Chronic stress predicts post-traumatic stress disorder symptoms via executive function deficits among urban American Indian children. Stress 2022; 25:97-104. [PMID: 35037551 DOI: 10.1080/10253890.2021.2024164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Little is known about how chronic exposure to stress affects mental health among American Indian (AI) children. The current study aimed to fill this gap by exploring if hair cortisol concentration (HCC), an indicator of chronic stress, predicted post-traumatic stress disorder (PTSD) symptoms through deficits in executive function (EF) skills commonly referred to as inhibitory control, working memory, and cognitive flexibility. A total of 163 urban AI children between 8- and 15-years old participated in the study (92 girls, 56.4%; Mage = 11.19, SD = 1.98). Chronic stress was measured as the concentration of cortisol in children's hair. EF deficits and PTSD symptoms were reported by primary caregivers using the Behavior Rating Inventory of Executive Function and the Trauma Symptom Checklist for Young Children. The results demonstrated that higher HCC was indirectly associated with more PTSD symptoms through deficits in EF skills. Specifically, higher levels of HCC were related to more symptoms of PTSD arousal through impaired working memory, and more symptoms of PTSD avoidance and Intrusion through deficits in cognitive flexibility. The findings suggest interventions that reduce or buffer chronic stress, or that focus on improving EF skills, may promote not only cognitive development but also the mental health of AI children.
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Affiliation(s)
- Juyoung Kim
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Longfeng Li
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Kevin M Korous
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Carlos Valiente
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
| | - Monica Tsethlikai
- School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
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Brockie TN, Hill K, Davidson PM, Decker E, Koh Krienke L, Nelson KE, Nicholson N, Werk AM, Wilson D, Around Him D. Strategies for culturally safe research with Native American communities: An integrative review. Contemp Nurse 2021; 58:8-32. [PMID: 34907854 PMCID: PMC9596189 DOI: 10.1080/10376178.2021.2015414] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background: A history of unethical research and deficit-based paradigms have contributed to profound mistrust of research among Native Americans, serving as an important call to action. Lack of cultural safety in research with Native Americans limits integration of cultural and contextual knowledge that is valuable for understanding challenges and making progress toward sustainable change.
Aim: To identify strategies for promoting cultural safety, accountability, and sustainability in research with Native American communities. Method: Using an integrative review approach, three distinct processes were carried out: (1) appraisal of peer-reviewed literature (Scopus, PubMed, and ProQuest), (2) review of grey literature (e.g. policy documents and guidelines), and (3) synthesis of recommendations for promoting cultural safety. Results: A total of 378 articles were screened for inclusion, with 55 peer-reviewed and grey literature articles extracted for full review. Recommendations from included articles were synthesised into strategies aligned with eight thematic areas for improving cultural safety in research with Native American communities. Conclusions: Research aiming to understand, respect, and acknowledge tribal sovereignty, address historical trauma, and endorse Indigenous methods is essential. Culturally appropriate, community-based and -engaged research collaborations with Native American communities can signal a reparative effort, re-establish trust, and inform pragmatic solutions. Rigorous research led by Native American people is critical to address common and complex health challenges faced by Native American communities. Impact statement: Respect and rigorous methods ensure cultural safety, accountability, and sustainability in research with Native Americans.
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Affiliation(s)
- Teresa N Brockie
- Johns Hopkins School of Nursing; 525 North Wolfe St. Room 455 Baltimore, MD 21205, E: P: +1 (410) 955-1730 Twitter: @TeresaBrockie
| | - Kyle Hill
- Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, Great Lakes Hub; 1915 South St. Duluth, MN 55812, E: P: +1 (410) 955-6931
| | - Patricia M Davidson
- University of Wollongong; Northfields Ave. Wollongong NSW 2522, Australia, E: P: +61 2 4221 3555 Twitter: @UOW_VC
| | - Ellie Decker
- Johns Hopkins School of Nursing; 525 North Wolfe St. Baltimore, MD, 21205 E: P: +1 (507) 469-4746
| | - Lydia Koh Krienke
- Johns Hopkins School of Nursing; 525 North Wolfe St. Baltimore, MD 21205 E: P: +1 (734) 660-6770
| | - Katie E Nelson
- Johns Hopkins School of Nursing; 525 North Wolfe St. Baltimore, MD 21205 E: P: +1 (507) 696-3902 Twitter: @itsnursekatie
| | - Natalie Nicholson
- Johns Hopkins School of Nursing; 525 North Wolfe St. Baltimore, MD, 21205 E: P: +1 (218) 444-4323 Twitter: @NNicholson10
| | - Alicia M Werk
- Aaniiih Nakoda College; 269 Blackfeet Ave. Harlem, MT, 59526 E: P: +1 (406) 654-4534
| | - Deborah Wilson
- Johns Hopkins School of Nursing; 525 North Wolfe St. Baltimore, MD 21205 E: P: +1 (413) 822-3632 Twitter: @DeborahWilsonRN
| | - Deana Around Him
- Child Trends; 7315 Wisconsin Avenue, Suite 1200W Bethesda, MD 20814 E: P: +1 (240) 223-9213 Twitter: @aroundhim_d
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Estradé M, Yan S, Trude AC, Fleischhacker S, Hinman S, Maudrie T, Jock BW, Redmond L, Pardilla M, Gittelsohn J. Individual- and household-level factors associated with fruit, vegetable, and dietary fiber adequacy among Native American adults in 6 reservation communities. Prev Med Rep 2021; 24:101414. [PMID: 34976600 PMCID: PMC8683900 DOI: 10.1016/j.pmedr.2021.101414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 05/15/2021] [Accepted: 05/25/2021] [Indexed: 11/12/2022] Open
Abstract
This study utilized baseline data collected in 2017 from the OPREVENT2 trial, which included 540 Native Americans in six Midwest and Southwest reservation communities. The objective was to identify correlates of fruit, vegetable, and dietary fiber adequacy among participants 18–75 years old who self-identified as the main food purchaser or preparer in their household. Mean daily servings of fruits and vegetables and grams of dietary fiber were quantified based on a 30-day semi-quantitative food frequency questionnaire. Participants consumed an average of 0.5 (±0.4) cup-equivalent servings of fruit, 2.5 (±1.8) cup-equivalent servings of vegetables, and 15.5 (±8.9) grams of fiber per day. <2% of the study population met the 2015–2020 Dietary Guidelines for Americans recommendations for fruit consumption, while 12 and 42% met recommendations for dietary fiber and vegetable consumption, respectively. Females had a prevalence ratio 1.4 times greater than males for adequate intakes of vegetables (p = 0.008) and over 6 times greater for dietary fiber (p < 0.001). Participants over the age of 30 were about twice as likely to meet dietary fiber recommendations (p = 0.031) compared to those 30 years and younger. Participants receiving food assistance from the USDA’s Food Distribution Program on Indian Reservations (FDPIR) were nearly twice as likely as non-FDPIR recipients to meet recommendations for dietary fiber (p = 0.008). These findings can help guide the development of targeted interventions to improve diet quality; however, further work is needed to understand and address underlying reasons for low fruit consumption in these rural reservation communities.
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Wedekind LE, Mitchell CM, Andersen CC, Knowler WC, Hanson RL. Epidemiology of Type 2 Diabetes in Indigenous Communities in the United States. Curr Diab Rep 2021; 21:47. [PMID: 34807308 PMCID: PMC8665733 DOI: 10.1007/s11892-021-01406-3] [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] [Accepted: 07/21/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW The present review focuses on the epidemiology of type 2 diabetes (T2D) in Indigenous communities in the continental United States (U.S.)-including disease prevention and management-and discusses special considerations in conducting research with Indigenous communities. RECENT FINDINGS Previous studies have reported the disparately high prevalence of diabetes, especially T2D, among Indigenous peoples in the U.S. The high prevalence and incidence of early-onset T2D in Indigenous youth relative to that of all youth in the U.S. population pose challenges to the prevention of complications of diabetes. Behavioral, dietary, lifestyle, and genetic factors associated with T2D in Indigenous communities are often investigated. More limited is the discussion of the historical and ongoing consequences of colonization and displacement that impact the aforementioned risk factors. Future research is necessary to assess community-specific needs with respect to diabetes prevention and management across the diversity of Indigenous communities in the U.S.
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Affiliation(s)
- Lauren E Wedekind
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA
- Nuffield Department of Medicine, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Cassie M Mitchell
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA
| | - Coley C Andersen
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA
| | - William C Knowler
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA
| | - Robert L Hanson
- Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 1550 East Indian School Road, Phoenix, AZ, 85014, USA.
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Thomas M, McCoy T, Jeffries I, Haverkate R, Naswood E, Leston J, Platero L. Native American Two Spirit and LGBTQ health: a systematic review of the literature. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2021. [DOI: 10.1080/19359705.2021.1913462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Morgan Thomas
- Northwest Portland Area Indian Health Board, Portland, USA
| | | | | | | | | | - Jessica Leston
- Northwest Portland Area Indian Health Board, Portland, USA
| | - Laura Platero
- Northwest Portland Area Indian Health Board, Portland, USA
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Lillie KM, Jansen KJ, Dirks LG, Lyons AJ, Alcover KC, Avey JP, Hirchak K, Herron J, Buchwald D, Donovan DM, McDonell MG, Shaw JL. Assessing the Predictive Validity of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) in Alaska Native and American Indian People. J Addict Med 2021; 14:e241-e246. [PMID: 32371661 PMCID: PMC7541407 DOI: 10.1097/adm.0000000000000661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The objective of this study was to examine the predictive validity of the Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES) among Alaska Native and American Indian (ANAI) people with an alcohol use disorder. METHODS The sample was 170 ANAI adults with an alcohol use disorder living in Anchorage, Alaska who were part of a larger alcohol intervention study. The primary outcome of this study was alcohol use as measured by mean urinary ethyl glucuronide (EtG). EtG urine tests were collected at baseline and then up to twice a week for four weeks. We conducted bivariate linear regression analyses to evaluate associations between mean EtG value and each of the three SOCRATES subscales (Recognition, Ambivalence, and Taking Steps) and other covariates such as demographic characteristics, alcohol use history, and chemical dependency service utilization. We then performed multivariable linear regression modeling to examine these associations after adjusting for covariates. RESULTS After adjusting for covariates, mean EtG values were negatively associated with the Taking Steps (P = 0.017) and Recognition (P = 0.005) subscales of the SOCRATES among ANAI people living in Alaska. We did not find an association between mean EtG values and the Ambivalence subscale (P = 0.129) of the SOCRATES after adjusting for covariates. CONCLUSIONS Higher scores on the Taking Steps and Recognition subscales of the SOCRATES at baseline among ANAI people predicted lower mean EtG values. This study has important implications for communities and clinicians who need tools to assist ANAI clients in initiating behavior changes related to alcohol use.
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Affiliation(s)
- Kate M Lillie
- Southcentral Foundation, 4085 Tudor Centre Drive, Anchorage, AK (KML, KJJ, JPA, JLS); Information School, University of Washington, Box 352840, Mary Gates Hall, Seattle, WA (LGD); Elson S. Floyd College of Medicine, Washington State University, 412 E. Riverpoint BLVD, Spokane, WA (AJL, KCA, MGMD); Center on Alcoholism, Substance Abuse, and Addictions, University of New Mexico, 2650 Yale Blvd SE, Albuquerque, NM (KH); Department of Psychology, University of New Mexico, Albuquerque, NM (JH); Institute for Research and Education to Advance Community Health and Partnerships for Native Health, Washington State University, 1100 Olive Way, Ste 1200, Seattle, WA (DB); Department of Psychiatry and Behavioral Sciences and Alcohol and Drug Abuse Institute, University of Washington, 1107 NE 45th Street, Suite 120, Seattle, WA (DMD)
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Coser A, Kominsky TK, White EJ. For the Good of the Community: Considering the Impact of Evidence-Based Treatment Adaptation on Tribal Communities. THE BEHAVIOR THERAPIST 2021; 44:161-170. [PMID: 34539031 PMCID: PMC8445390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Ongoing discussions among tribal communities, professionals, and mental health organizations have centered on the question of whether evidence-based interventions require adaptations to improve mental health outcomes among American Indian communities. Continued efforts to address these questions have resulted in the development of novel, culturally-grounded interventions, adapted interventions, use of original standard protocols, and/or limited use of evidence-based treatments. Consequently, mental health services in tribal communities may be highly variable from one community to another and the effectiveness of services relatively unknown. The current paper explored the state of the literature on adaptations and their utility among American Indian communities and the broader ethnic minority community. Considerations for the various impacts on tribal communities are presented and recommendations for researchers and practitioners are also discussed.
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Affiliation(s)
| | | | - Evan J. White
- Laureate Insitute for Brain Research, Tulsa, OK, USA
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32
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Harry ML, Coley RY, Waring SC, Simon GE. Evaluating the Cross-Cultural Measurement Invariance of the PHQ-9 between American Indian/Alaska Native Adults and Diverse Racial and Ethnic Groups. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 4:100121. [PMID: 34142103 PMCID: PMC8208497 DOI: 10.1016/j.jadr.2021.100121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Patient Health Questionnaire-9 (PHQ-9), a self-reported depression screening instrument for measurement-based care (MBC), may have cross-cultural measurement invariance (MI) with a regional group of American Indian/Alaska Native (AI/AN) and non-Hispanic White adults. However, to ensure health equity, research was needed on the cross-cultural MI of the PHQ-9 between other groups of AI/AN peoples and diverse populations. METHODS We assessed the MI of the one-factor PHQ-9 model and five previously identified two-factor models between non-Hispanic AI/AN adults (ages 18-64) from healthcare systems A (n=1,759) and B (n=2,701) using secondary data and robust maximum likelihood estimation. We then tested either fully or partially invariant models for MI between either combined or separate AI/AN groups, respectively, and Hispanic (n=7,974), White (n=7,974), Asian (n=6,988), Black (n=6,213), and Native Hawaiian/Pacific Islander (n=1,370) adults from healthcare system B. All had mental health or substance use disorder diagnoses and were seen in behavioral health or primary care from 1/1/2009-9/30/2017. RESULTS The one-factor PHQ-9 model was partially invariant, with two-factor models partially, or in one case fully, invariant between AI/AN groups. The one-factor model and three two-factor models were partially invariant between all seven groups, while a two-factor model was fully invariant and another partially invariant between a combined AI/AN group and other racial and ethnic groups. CONCLUSIONS Achieving health equity in MBC requires ensuring the cross-cultural validity of measurement tools. Before comparing mean scores, PHQ-9 models should be assessed for individual racial and ethnic group fit for adults with mental health or substance use disorders.
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Affiliation(s)
- Melissa L. Harry
- Essentia Health, Essentia Institute of Rural Health, 502 East Second Street, Duluth, MN 55805
| | - R. Yates Coley
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1466
| | - Stephen C. Waring
- Essentia Health, Essentia Institute of Rural Health, 502 East Second Street, Duluth, MN 55805
| | - Gregory E. Simon
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101-1466
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Hirchak KA, Tonigan JS, Hernandez-Vallant A, Herron J, Cloud V, Venner KL. The Validity of the Short Inventory of Problems and Drinking Intensity among Urban American Indian Adults. Subst Use Misuse 2021; 56:501-509. [PMID: 33605847 PMCID: PMC8095341 DOI: 10.1080/10826084.2021.1883656] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND American Indian (AI) adults have both high prevalence rates of alcohol abstinence and alcohol use disorders compared to non-Hispanic White adults. We investigated the applicability and validity of the Short Inventory of Problems (SIP) among AI urban adults and the moderating effect of biological sex. METHODS AI adults from three Alcoholics Anonymous samples (n = 124) provided baseline, 3-, 6- and 9-month data. Measures included Form 90 and the SIP, which includes 5 domains of alcohol-related negative consequences including interpersonal, intrapersonal, physical, impulse control and social. Drinking frequency and intensity were assessed by percent days abstinent (PDA) and drinks per drinking day (DPDD). RESULTS Cronbach alphas of the SIP were similar between urban AI adults and the mainstream treatment-seeking population reported in the SIP manual. DPDD was a significant and positive predictor of all five SIP scales collected 9-months later. Higher PDA was significantly and negatively associated with later consequences, and all 5 SIP scales. Moderation tests indicated that the association between consequences and drinking intensity was stronger for AI females with fewer drinking days resulting in significantly fewer consequences for AI males relative to AI females. CONCLUSIONS Findings highlight the acceptability of SIP as a measure to assess drinking related consequences among AI urban adults, with clinical implications related to alcohol use and sex. Further research is warranted to examine differential drinking related outcomes among AI men and women in addition to adaptations of the SIP that more fully capture the range of negative drinking consequences.
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Affiliation(s)
- Katherine A Hirchak
- Department of Medical Education and Clinical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA.,Center on Alcohol, Substance use And Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA
| | - J Scott Tonigan
- Center on Alcohol, Substance use And Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA.,Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | | | - Jalene Herron
- Center on Alcohol, Substance use And Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA.,Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Violette Cloud
- Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Kamilla L Venner
- Center on Alcohol, Substance use And Addictions (CASAA), University of New Mexico, Albuquerque, New Mexico, USA.,Department of Psychology, University of New Mexico, Albuquerque, New Mexico, USA
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Walls M, Sittner KJ, Whitbeck LB, Herman K, Gonzalez M, Elm JHL, Hautala D, Dertinger M, Hoyt DR. Prevalence of Mental Disorders from Adolescence through Early Adulthood in American Indian and First Nations Communities. Int J Ment Health Addict 2020; 19:2116-2130. [PMID: 35002580 PMCID: PMC8734560 DOI: 10.1007/s11469-020-00304-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Melissa Walls
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | | | - Les B. Whitbeck
- University of Nebraska, Lincoln, Department of Sociology, Lincoln, NE
| | - Kaley Herman
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | - Miigis Gonzalez
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | - Jessica H. L. Elm
- Johns Hopkins University, Department of International Health; Center for American Indian Health; 1915 South Street, Duluth, MN 55812
| | - Dane Hautala
- University of Minnesota, Department of Psychiatry, Minneapolis, MN
| | - Melinda Dertinger
- University of Minnesota Medical School, Duluth campus, Department of Family Medicine & Biobehavioral Health
| | - Dan R. Hoyt
- University of Nebraska, Lincoln, Department of Sociology, Lincoln, NE
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Austin AE, Gottfredson NC, Marshall SW, Halpern CT, Zolotor AJ, Parrish JW, Shanahan ME. Heterogeneity in Risk and Protection Among Alaska Native/American Indian and Non-Native Children. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2020; 21:86-97. [PMID: 31773468 PMCID: PMC7364379 DOI: 10.1007/s11121-019-01052-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Currently, little is known about patterns of co-occurring risk and protective factors among young children. Understanding variations in co-occurring risk and protective factors among children in Alaska is important as experiences of collective trauma may contribute to differences in the intersection of risk and protective factors between Alaska Native/American Indian (AN/AI) and non-Native children. Using data from the Alaska Longitudinal Child Abuse and Neglect Linkage (ALCANLink) project, a linkage of the 2009-2011 Alaska Pregnancy Risk Assessment Monitoring System survey and administrative data sources, and the 2012-2014 Childhood Understanding Behaviors Survey, we conducted latent class analysis to identify classes of AN/AI (N = 593) and non-Native (N = 1018) children in terms of seven risk factors (poverty, maternal depression, maternal binge drinking, parental incarceration, intimate partner violence exposure, other violence exposure, child maltreatment) and four protective factors (father figure involvement, reading by adults, family meals, peer interactions) experienced prior to age 3 years. We identified two classes among AN/AI children: (1) high risk-moderate protection (29.1%) and (2) low socioeconomic status-high protection (70.9%). We identified two classes among non-Native children: (1) moderate risk-high protection (32.9%) and (2) low risk-high protection (67.1%). A test of invariance revealed that risk and protective factor probabilities differed significantly for corresponding classes of AN/AI and non-Native children. Overall, results demonstrate heterogeneity within and between AN/AI and non-Native children in early experiences of risk and protection and suggest that interventions will be more effective if tailored to the experiences and developmental needs of specific groups of Alaska children.
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Affiliation(s)
- Anna E Austin
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | | | | | | | - Adam J Zolotor
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jared W Parrish
- Alaska Department of Health and Social Services, Anchorage, AK, USA
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Parker M, Pearson C, Donald C, Fisher CB. Beyond the Belmont Principles: A Community-Based Approach to Developing an Indigenous Ethics Model and Curriculum for Training Health Researchers Working with American Indian and Alaska Native Communities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:9-20. [PMID: 31355974 PMCID: PMC6750973 DOI: 10.1002/ajcp.12360] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Individuals responsible for carrying out research within their diverse communities experience a critical need for research ethics training materials that align with community values. To improve the capacity to meet local human subject protections, we created the research Ethics Training for Health in Indigenous Communities (rETHICS), a training curriculum aligned within American Indian and Alaska Native (AI/AN) context, culture, and community-level ethical values and principles. Beginning with the Belmont Report and the Common Rule that defines research with human subjects (46 CFR 45), the authors convened three different expert panels (N = 37) to identify Indigenous research values and principles common across tribal communities. The resulting culturally grounded curriculum was then tested with 48 AI/AN individuals, 39 who also had recorded debriefing interviews. Using a thematic analysis, we coded the qualitative feedback from the expert panel discussions and the participant debriefings to assess content validity. Participants identified five foundational constructs needed to ensure cultural-grounding of the AI/AN-specific research training curriculum. These included ensuring that the module was: (a) framed within an AI/AN historical context; (b) reflected Indigenous moral values; (c) specifically linked AI/AN cultural considerations to ethical procedures; (d) contributed to a growing Indigenous ethics; and (e) provided Indigenous-based ethics tools for decision making. Using community-based consultation and feedback from participants led to a culturally grounded training curriculum that teaches research ethical principles and procedures for conducting research with AI/ANs. The curriculum is available for free and the community-based process used can be adapted for other cultural groups.
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Affiliation(s)
- Myra Parker
- Department of Psychiatry and Behavioral Sciences, Center for the Study of Health and Risk Behavior, School of Medicine, University of Washington, Seattle, WA, USA
| | - Cynthia Pearson
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Caitlin Donald
- Prevention Research Center, Oregon Health Sciences University, Portland, OR, USA
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Montag AC, Romero R, Jensen T, Goodblanket A, Admire A, Whitten C, Calac D, Akshoomoff N, Sanchez M, Zacarias M, Zellner JA, del Campo M, Jones KL, Chambers CD. The Prevalence of Fetal Alcohol Spectrum Disorders in An American Indian Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122179. [PMID: 31226736 PMCID: PMC6617116 DOI: 10.3390/ijerph16122179] [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: 05/04/2019] [Revised: 06/04/2019] [Accepted: 06/10/2019] [Indexed: 12/03/2022]
Abstract
The prevalence of fetal alcohol spectrum disorders (FASD) differs among populations and is largely unknown among minority populations. Prevalence and characterization of FASD is necessary for prevention efforts and allocation of resources for treatment and support. However, prevalence data are lacking, including among many minority populations. The aim of this study was to obtain an FASD prevalence estimate in a Southern California American Indian community employing active case-ascertainment. In 2016, American Indian children aged 5–7 years and their caregivers were recruited in collaboration with Southern California Tribal Health Clinic. Children were assessed using physical examinations and neurobehavioral testing. Parent or guardian interviews assessed child behavior and prenatal exposures including alcohol. Of 488 children identified as eligible to participate, 119 families consented and 94 completed assessments to allow a classification for FASD. Participating children (n = 94) were an average of 6.61 ± 0.91 years old and half were female. Most interviews were conducted with biological mothers (85.1%). Less than one third (29.8%) of mothers reported consuming any alcohol in pregnancy and 19.1% met study criteria for risky alcohol exposure prior to pregnancy recognition. Overall 20 children met criteria for FASD, resulting in an estimated minimum prevalence of 41.0 per 1000 (4.1%). No cases of fetal alcohol syndrome (FAS) were identified; 14 (70.0%) met criteria for alcohol related neuro- developmental disorder (ARND). Minimum prevalence estimates found in this sample are consistent with those noted in the general population.
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Affiliation(s)
- Annika C. Montag
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA; (M.S.); (M.Z.); (J.A.Z.); (M.d.C.); (K.L.J.); (C.D.C.)
- Correspondence: ; Tel.: +1-858-246-1755
| | | | - Toni Jensen
- Southern California Tribal Health Clinic; (C.W.)
| | | | - Ami Admire
- Southern California Tribal Health Clinic; (C.W.)
| | | | - Daniel Calac
- Southern California Tribal Health Clinic; (C.W.)
| | - Natacha Akshoomoff
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093-0828, USA;
| | - Maria Sanchez
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA; (M.S.); (M.Z.); (J.A.Z.); (M.d.C.); (K.L.J.); (C.D.C.)
| | - MarLa Zacarias
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA; (M.S.); (M.Z.); (J.A.Z.); (M.d.C.); (K.L.J.); (C.D.C.)
| | - Jennifer A. Zellner
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA; (M.S.); (M.Z.); (J.A.Z.); (M.d.C.); (K.L.J.); (C.D.C.)
| | - Miguel del Campo
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA; (M.S.); (M.Z.); (J.A.Z.); (M.d.C.); (K.L.J.); (C.D.C.)
| | - Kenneth Lyons Jones
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA; (M.S.); (M.Z.); (J.A.Z.); (M.d.C.); (K.L.J.); (C.D.C.)
| | - Christina D. Chambers
- Department of Pediatrics, University of California San Diego, La Jolla, CA 92093-0828, USA; (M.S.); (M.Z.); (J.A.Z.); (M.d.C.); (K.L.J.); (C.D.C.)
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, CA 92093-0828, USA
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Isaac G, Finn S, Joe JR, Hoover E, Gone JP, Lefthand-Begay C, Hill S. Native American Perspectives on Health and Traditional Ecological Knowledge. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:125002. [PMID: 30675814 PMCID: PMC6371761 DOI: 10.1289/ehp1944] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 09/18/2018] [Accepted: 10/10/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND Traditional ecological knowledge (TEK) is a conceptual framework that highlights Indigenous knowledge (IK) systems. Although scientific literature has noted the relevance of TEK for environmental research since the 1980s, little attention has been given to how Native American (NA) scholars engage with it to shape tribal-based research on health, nor how non-Native scholars can coordinate their approaches with TEK. This coordination is of particular importance for environmental health sciences (EHS) research exploring interdisciplinary approaches and the integration of environmental and human health. OBJECTIVE Our perspective on TEK arose from a series of Health and Culture Research Group (HCRG) workshops that identified gaps in existing EHS methodologies that are based on a reliance on Euro-American concepts for assessing environmental exposures in tribal communities. These prior methods neither take into account cultural behavior nor community responses to these. Our objective is to consider NA perspectives on TEK when analyzing relationships between health and the environment and to look at how these may be applied to address this gap. DISCUSSION The authors—the majority of whom are NA scholars—highlight two research areas that consider health from a TEK perspective: food systems and knowledge of medicinal plants. This research has yielded data, methods, and knowledge that have helped Indigenous communities better define and reduce health risks and protect local natural food resources, and this TEK approach may prove of value to EHS research. CONCLUSION NA perspectives on TEK resulting from the HCRG workshops provide an opportunity for developing more accurate Indigenous health indicators (IHI) reflecting the conceptualizations of health maintained in these communities. This approach has the potential to bridge the scientific study of exposure with methods addressing a tribal perspective on the sociocultural determinants of health, identifying potential new areas of inquiry in EHS that afford nuanced evaluations of exposures and outcomes in tribal communities. https://doi.org/10.1289/EHP1944.
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Affiliation(s)
- Gwyneira Isaac
- Department of Anthropology, National Museum of Natural History, Smithsonian Institution, Washington, DC, USA
| | - Symma Finn
- National Institute of Environmental Health Sciences, Durham, North Carolina, USA
| | - Jennie R. Joe
- Department of Family and Community Medicine in the College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Elizabeth Hoover
- Department of American Studies, Brown University, Providence, Rhode Island, USA
| | - Joseph P. Gone
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Stewart Hill
- Natural Resources Institute, University of Manitoba, Manitoba, Canada
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Symons M, Pedruzzi RA, Bruce K, Milne E. A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities. BMC Public Health 2018; 18:1227. [PMID: 30390661 PMCID: PMC6215602 DOI: 10.1186/s12889-018-6139-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/22/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work. METHOD The MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO, SocINDEX, and Informit databases were searched from inception to 22/08/2017 for all prevention and intervention papers published in peer-reviewed scientific journals, with results, targeting prenatal alcohol exposure and FASD in Indigenous populations. This review was limited to studies published in English and excluded interventions focusing on the workforce. All steps were completed independently by two reviewers with discrepancies resolved via consensus with the senior author. RESULTS There was significant heterogeneity in the ten included studies. Populations targeted included non-pregnant women of child-bearing age, pregnant women, school children and the general public. Study designs included one randomised controlled trial, five cohort studies with pre-post design, one cross-sectional study with different pre- and post-intervention groups, and four studies collected post-intervention data. Studies assessed changes in knowledge, and/or changes in risk for prenatal alcohol exposure including self-reported alcohol consumption, use of birth control or a combination of both. One study was conducted in Australia and nine in the US. The methodological quality of all studies was rated as 'Poor' using the systematic review assessment tools developed by The National Heart, Lung and Blood Institute. Studies were subject to substantial bias due to issues such as high loss to follow-up, lack of control groups and the reliance on self-report measures to assess the main outcome. CONCLUSION Overall, there is little evidence that previous interventions aiming to reduce the risk of prenatal alcohol exposure or FASD in Indigenous populations have been effective. Future intervention studies should address the cultural factors and historical context that are fundamental to successful work with Indigenous populations, and be designed, implemented and evaluated using rigorous methods. This systematic review was registered with PROSPERO, CRD42018086212.
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Affiliation(s)
- Martyn Symons
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, Perth, Australia
| | - Rebecca Anne Pedruzzi
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Kaashifah Bruce
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
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Whitesell NR, Bolan M, Chomos JC, Heath D, Miles J, Salvador M, Whitmore C, Barlow A. MEASUREMENT ISSUES IN HOME-VISITING RESEARCH WITHIN TRIBAL COMMUNITIES: CHALLENGES AND STRATEGIES. Infant Ment Health J 2018; 39:326-334. [PMID: 29726610 DOI: 10.1002/imhj.21713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In this article, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees share strategies they have developed and adopted to address the most common barriers to effective measurement (and thus to effective evaluation) encountered in the course of implementation and evaluation of their home-visiting programs. We identify key challenges in measuring outcomes in Tribal MIECHV Programs and provide practical examples of various strategies used to address these challenges within diverse American Indian and Alaska Native cultural and contextual settings. Notably, high-quality community engagement is a consistent thread throughout these strategies and fundamental to successful measurement in these communities. These strategies and practices reflect the experiences and innovative solutions of practitioners working on the ground to deliver and evaluate intervention programs to tribal communities. They may serve as models for getting high-quality data to inform intervention while working within the constraints and requirements of program funding. The utility of these practical solutions extends beyond the Tribal MIECHV grantees and offers the potential to inform a broad array of intervention evaluation efforts in tribal and other community contexts.
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Affiliation(s)
| | | | | | - Debra Heath
- University of New Mexico Health Sciences Center
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Whitesell NR, Sarche M, Keane E, Mousseau AC, Kaufman CE. Advancing Scientific Methods in Community and Cultural Context to Promote Health Equity: Lessons From Intervention Outcomes Research With American Indian and Alaska Native Communities. THE AMERICAN JOURNAL OF EVALUATION 2018; 39:42-57. [PMID: 31649477 PMCID: PMC6812651 DOI: 10.1177/1098214017726872] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Evidence-based interventions hold promise for reducing gaps in health equity across diverse populations, but evidence about effectiveness within these populations lags behind the mainstream, often leaving opportunities to fulfill this promise unrealized. Mismatch between standard intervention outcomes research methods and the cultural and community contexts of populations at greatest risk presents additional challenges in designing and implementing rigorous studies; these challenges too often impede efforts to generate needed evidence. We draw on experiences with American Indian and Alaska Native (AIAN) communities to illustrate how consideration of culture and context can constructively shape intervention research and improve the quality of evidence produced. Case examples from a partnership with one AI community highlight opportunities for increasing alignment in intervention development, research design, and study implementation to maximize both validity and feasibility. We suggest that responsively tailoring intervention outcome research to cultural and community contexts is fundamental to supporting health equity.
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Affiliation(s)
- Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michelle Sarche
- Centers for American Indian and Alaska Native Health, Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Ellen Keane
- Centers for American Indian and Alaska Native Health, Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Alicia C Mousseau
- Centers for American Indian and Alaska Native Health, Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Carol E Kaufman
- Centers for American Indian and Alaska Native Health, Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Montag AC, Dusek ML, Ortega ML, Camp-Mazzetti A, Calac DJ, Chambers CD. Tailoring an Alcohol Intervention for American Indian Alaska Native Women of Childbearing Age: Listening to the Community. Alcohol Clin Exp Res 2017; 41:1938-1945. [PMID: 28833270 DOI: 10.1111/acer.13485] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 08/17/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Reduction of risky drinking in women of childbearing age is 1 strategy that may be employed to prevent fetal alcohol spectrum disorder, a sequela of prenatal alcohol exposure. Communities differ in risk and protective factors, necessitating culturally informed interventions for maximal efficacy. This article describes the modification of an existing web-based screening, brief intervention, and referral to treatment intervention to reduce risky drinking among American Indian Alaska Native (AIAN) women of childbearing age in Southern California into a peer-to-peer-based intervention using motivational interviewing (MI). METHODS The modification process was iterative and included various community focus groups, interviews, and a final review. RESULTS Intervention modification was required for cultural congruence. Components of the peer-to-peer intervention designed by this project included a flip chart used to guide the motivational interviewing, charts of the financial and physical costs of alcohol consumption, revised baseline and follow-up questionnaires, and guidance regarding the application of MI techniques. CONCLUSIONS This study may inform the modification of future interventions among AIAN communities.
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Affiliation(s)
- Annika C Montag
- Department of Pediatrics , University of California San Diego, San Diego, California
| | - Marlené L Dusek
- Southern California Tribal Health Clinic , San Diego, California
| | - Marina L Ortega
- Southern California Tribal Health Clinic , San Diego, California
| | | | - Dan J Calac
- Southern California Tribal Health Clinic , San Diego, California
| | - Christina D Chambers
- Department of Pediatrics , University of California San Diego, San Diego, California
- Department Family Medicine and Public Health , University of California San Diego, San Diego, California
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