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Kaufman CE, Asdigian NL, Reed ND, Shrestha U, Bull S, Begay RL, Shangreau C, Howley CT, Vossberg RL, Sarche M. A virtual randomized controlled trial of an alcohol-exposed pregnancy prevention mobile app with urban American Indian and Alaska Native young women: Native WYSE CHOICES rationale, design, and methods. Contemp Clin Trials 2023; 128:107167. [PMID: 37001855 PMCID: PMC10290431 DOI: 10.1016/j.cct.2023.107167] [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: 01/06/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Fetal Alcohol Spectrum Disorders (FASD) result in lifelong disability and are a leading cause of preventable birth defects in the US, including for American Indian and Alaska Natives (AIANs). Prevention of alcohol exposed pregnancies (AEPs), which can cause FASD, is typically aimed at adult women who are risky drinkers and have unprotected sex. Among AIANs, AEP prevention research has been primarily conducted in reservation communities, even though over 70% of AIANs live in urban areas. Culturally appropriate AEP prevention for urban AIAN young women, regardless of current drinking or sexual behaviors, may maximize the potential for primary prevention at the beginning of the reproductive years for this underserved population. METHODS We developed a virtual randomized controlled trial (RCT) - fully implemented through technology - to evaluate Native WYSE CHOICES, a culturally tailored mobile app, with urban AIAN young women ages 16-20 nationally. While virtual RCTs are not new, this is the first engaging a solely urban AIAN population, historically excluded from research. Participants are recruited on a rolling basis through the project social media community, organizational partnerships, and in-person events. Eligible participants complete a baseline survey and are randomized to either the app's intervention or comparison arm - each of which provide about 3 h of content. Follow-up data are collected at 1-, 6-, and 12-months post-baseline. RESULTS Our study offers a template for building trust and extending reach to this underserved population while also providing important lessons and insights on advances in virtual or hybrid research approaches.
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Affiliation(s)
- Carol E Kaufman
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Nancy L Asdigian
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Nicole D Reed
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Umit Shrestha
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Sheana Bull
- mHealth Impact Lab, Department of Community and Behavioral Health, Colorado School of Public Health, Mail Stop F802, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Rene L Begay
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Carly Shangreau
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Caitlin Trucksess Howley
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Raeann L Vossberg
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Michelle Sarche
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
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Abbott KM, Boyens BMS, Gubbels JAA. Intergenerational Talking Circles Exploring Psychosocial Stressors for Preterm Birth and Strategies for Resilience among American Indian Women. J Transcult Nurs 2022; 33:268-277. [PMID: 35240887 DOI: 10.1177/10436596221081269] [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: 11/17/2022] Open
Abstract
INTRODUCTION This study used phenomenological qualitative research design to understand the primary psychosocial stressors American Indian (AI) women face during pregnancy-factors that may be overlooked as contributing to the community's heightened preterm birth rate-and to identify mechanisms of resilience. METHOD Using Lakota talking circles (TCs) as the data collection method, researchers collected young mothers' and tribal elders' narratives about pregnancy and parenting. Themes were derived and verified from the transcripts. RESULTS During the TCs, the women identified transgenerational/historical trauma and instability in housing, childcare, and relationships as major contributors to pregnancy and parenting stress. DISCUSSION Having overcome obstacles while bearing and raising children, AI women exhibit resilience. Participants indicated that the TCs provided support and a cultural connection, thus serving as both a data collection method and an intervention. Future work will involve using TCs to support young mothers, transmit elder wisdom, and increase resilience among AI women.
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Saftner M, Thompson M, Ngabirano TD, McMorris BJ. Adaptation of the event history calendar for Ugandan adolescents. Glob Health Promot 2019; 27:159-170. [PMID: 31749404 DOI: 10.1177/1757975919878179] [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: 11/16/2022]
Abstract
Adolescent and emerging adult risk behavior is a concern globally. Discussing health promotive and risk behaviors with adolescents and young adults can be challenging regardless of the country of data collection and dominant culture. In the United States, event history calendars have been used in both research and clinical settings to identify healthy and risky behaviors among adolescents and emerging adults, and contextual factors that may influence their behavior. After an unsuccessful attempt to employ a particular event history calendar on family life, negative and positive events, sexual behavior and substance use in data collection in rural fishing villages in Western Uganda, the current study aimed to modify the United States validated event history calendar for use with adolescents in Uganda, as a first step to cultural adaptation. Focus groups with 24 college students provided information about ways to modify the event history calendar for Ugandan youth. This paper discusses the modifications of the event history calendar for Ugandan young people.
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Affiliation(s)
- Melissa Saftner
- School of Nursing, University of Minnesota, Minneapolis, USA
| | - Meagan Thompson
- School of Nursing, University of Minnesota, Minneapolis, USA.,Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
| | | | - Barbara J McMorris
- School of Nursing, University of Minnesota, Minneapolis, USA.,Division of General Pediatrics and Adolescent Health, University of Minnesota, Minneapolis, USA
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Saftner MA, Pruitt KS, McRee AL. Conversation, Condoms, and Contraception: How Does Communication With Sexual Partners Affect Safer Sexual Behaviors Among American Indian Youth? J Sch Nurs 2019; 37:109-116. [DOI: 10.1177/1059840519849097] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Communication with sexual partners about protection against sexually transmitted infections (STIs) is associated with safer sexual behaviors among general populations of youth, but little is known about partner communication among American Indian youth. We assessed the prevalence of adolescents’ communication with sexual partners about STI prevention and used multivariable logistic regression to examine associations between communication and safer sexual behaviors (condom use, reliable contraceptive use, and dual method use) among a statewide sample of in-school, American Indian youth in Minnesota in 2013 and 2016 ( n = 739). Half (49.5%) of sexually experienced American Indian youth reported talking about STI prevention at least once with every sexual partner. Communication was associated with all examined safer sexual behaviors among females and only with condom use among males. Study findings highlight the importance of school nurses, health educators, and other clinicians addressing partner communication when counseling adolescent patients.
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Affiliation(s)
| | - Kelsey S. Pruitt
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
- Division of General Pediatrics and Adolescent Health, Medical School, University of Minnesota, Duluth, MN, USA
| | - Annie-Laurie McRee
- Division of General Pediatrics and Adolescent Health, Medical School, University of Minnesota, Duluth, MN, USA
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Im EO, Lee Y. Transcultural Nursing: Current Trends in Theoretical Works. Asian Nurs Res (Korean Soc Nurs Sci) 2018; 12:157-165. [DOI: 10.1016/j.anr.2018.08.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/20/2018] [Indexed: 12/01/2022] Open
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Munro-Kramer ML, Fava NM, Banerjee T, Darling-Fisher CS, Pardee M, Villarruel AM, Martyn KK. The Effect of a Youth-Centered Sexual Risk Event History Calendar (SREHC) Assessment on Sexual Risk Attitudes, Intentions, and Behavior. J Pediatr Health Care 2017; 31:302-313. [PMID: 27773349 PMCID: PMC5398950 DOI: 10.1016/j.pedhc.2016.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/09/2016] [Accepted: 09/11/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The purpose of this study was to examine the effect of a youth-centered assessment, the Sexual Risk Event History Calendar (SREHC), compared with the Guidelines for Adolescent Preventive Services (GAPS) assessment, on sexual risk attitudes, intentions, and behaviors. METHODS The Interaction Model of Client Health Behavior guided this participatory research-based randomized control trial. Youth participants recruited from university and community clinics in the Midwestern United States were randomized to a health care provider visit using either the SREHC or GAPS and completed surveys at baseline, postintervention, and 3, 6, and 12 months. RESULTS Participants included 181 youth (15-25 years old) and nine providers. Findings showed that youth in the SREHC group reported stronger intentions to use condoms compared with those in the GAPS group. Age and race were also significant predictors of sexual experience. DISCUSSION This study highlights the importance of using a youth-centered, systematic approach in the assessment of sexual risk behaviors.
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Fava NM, Munro-Kramer ML, Felicetti IL, Darling-Fisher CS, Pardee M, Helman A, Trucco EM, Martyn KK. Patient-Centered Participatory Research in Three Health Clinics: Benefits, Challenges, and Lessons Learned. West J Nurs Res 2016; 38:1509-1530. [PMID: 27338752 PMCID: PMC5182169 DOI: 10.1177/0193945916654665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research informed by individuals' lived experiences is a critical component of participatory research and nursing interventions for health promotion. Yet, few examples of participatory research in primary care settings with adolescents and young adults exist, especially with respect to their sexual health and health-risk behaviors. Therefore, we implemented a validated patient-centered clinical assessment tool to improve the quality of communication between youth patients and providers, sexual risk assessment, and youths' health-risk perception to promote sexual health and reduce health-risk behaviors among adolescents and young adults in three community health clinic settings, consistent with national recommendations as best practices in adolescent health care. We describe guiding principles, benefits, challenges, and lessons learned from our experience. Improving clinical translation of participatory research requires consideration of the needs and desires of key stakeholders (e.g., providers, patients, and researchers) while retaining flexibility to successfully navigate imperfect, real-world conditions.
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Arat G, Liu LL, Wong PWC. Culturally Relevant Protective and Risk Factors of Youth Risk Behaviors Among Pakistani and Indian Students in Hong Kong: A Focus Group Study. J Transcult Nurs 2016; 28:573-581. [PMID: 27609599 DOI: 10.1177/1043659616668397] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
PURPOSE The risk behaviors of Hong Kong ethnic minority students are understudied. This exploratory qualitative study aimed to explore culturally nuanced factors for the development and prevention of risk behaviors among Pakistani and Indian students in Hong Kong. METHOD Twenty-three students participated in four focus groups. All interviews were transcribed verbatim and analyzed using thematic analysis. RESULTS The participants reported bullying, delinquency, gambling, alcohol, cigarette, and drug uses as risk behaviors. Four themes emerged in the development and prevention of risk behaviors: (a) Parental and peer influence, (b) An unsafe community environment were perceived by the participants as essential factors for the development of risk behaviors, (c) Parental monitoring, and (d) Strong religious beliefs were believed as protective factors for the prevention of risk behaviors. CONCLUSION Further research and practice may investigate and focus on the factors embedded in the Hong Kong ethnic minorities' sociocultural contexts to prevent risk behaviors.
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Affiliation(s)
- Gizem Arat
- 1 The University of Hong Kong, Pokfulam, Hong Kong SAR, P.R. China
| | - Lucia L Liu
- 1 The University of Hong Kong, Pokfulam, Hong Kong SAR, P.R. China
| | - Paul W C Wong
- 1 The University of Hong Kong, Pokfulam, Hong Kong SAR, P.R. China
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Saftner MA. Family and Friend Influence on Urban-Dwelling American Indian Adolescent Girl's Sexual Risk Behavior. QUALITATIVE HEALTH RESEARCH 2016; 26:1561-1573. [PMID: 26612887 PMCID: PMC4882274 DOI: 10.1177/1049732315616627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Previous research with American Indian (AI) adolescent sexual risk behavior primarily focused on reservation-dwelling youth despite 70% of AIs living off Native lands. Using grounded theory methodology, I sampled 20 adolescent AI girls via talking circles and interviews to explore the perceptions of AI adolescent girls living in an urban, Midwest area about the influence of family and friends on their sexual behavior. Similar to research with other racial groups, participants cited their family and friends as a major influence. Five unique themes emerged related to family and friend influence. Urban-dwelling AI girls rely on their female family members and peers for information related to sex and receive varying messages from their networks of family and friends, which often overlap. AI youth have unique family groups yet have some similarities to other ethnic groups with regard to family and friend relationships that may allow for enhanced intervention development.
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Munro-Kramer ML, Fava NM, Saftner MA, Darling-Fisher CS, Tate NH, Stoddard SA, Martyn KK. What are we missing? Risk behaviors among Arab-American adolescents and emerging adults. J Am Assoc Nurse Pract 2016; 28:493-502. [PMID: 26990394 PMCID: PMC5010467 DOI: 10.1002/2327-6924.12352] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 01/16/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Research on Arab-Americans as a distinct ethnic group is limited, especially when considering the health of Arab-American youth. This study describes health risk (substance use, violence); health promotive behaviors (hope, spirituality); and sexual activity (oral, vaginal, anal sex) of Arab-American adolescents and emerging adults (aged 15-23) within their life context, as well as the association between these behaviors. METHODS A secondary analysis of data on a subset of Arab-American participants obtained from a randomized-control trial was utilized to conduct mixed methods analyses. Qualitative analyses completed on the open-ended questions used the constant comparative method for a subsample (n = 24) of participants. Descriptive quantitative analyses of survey data utilized bivariate analyses and stepwise logistic regression to explore the relation between risk behaviors and sexual activity among the full sample (n = 57). CONCLUSIONS Qualitative analyses revealed two groups of participants: (a) multiple risk behaviors and negative life-events, and (b) minimal risk behaviors and positive life-events. Quantitative analyses indicated older youth, smokers, and those with higher hope pathways were more likely to report vaginal sex. IMPLICATIONS FOR PRACTICE The unique cultural and social contexts of Arab-American youth provide a framework for recommendations for the prevention of risk behaviors.
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Affiliation(s)
| | - Nicole M. Fava
- Florida International Institute Robert Stempel College of Public Health & Social Work, 11200 SW 8 Street, AHC5 505, Miami, FL 33199, Telephone: 305-348-4903,
| | - Melissa A. Saftner
- University of Minnesota School of Nursing, 6-165 Weaver-Densford Hall, Minneapolis, MN 55455-0213, Telephone: 218-726-8934,
| | - Cynthia S. Darling-Fisher
- University of Michigan School of Nursing, 400 N. Ingalls, Room 3176, Ann Arbor, MI 48109-5482, Telephone: 734-647-0328,
| | - Nutrena H. Tate
- Wayne State University College of Nursing, 5557 Cass, 140 Cohn, Detroit, MI 48202, Telephone: 313-557-1754,
| | - Sarah A. Stoddard
- University of Michigan School of Nursing, 400 N. Ingalls, Room 3344, Ann Arbor, MI 48109-5482, Telephone: 734-647-0327,
| | - Kristy K. Martyn
- Director of the Doctor of Nursing Practice Program, Independence Chair in Nursing, Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road, NE, Rm 336, Atlanta, GA 30322, Telephone: 404-727-6913,
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Wu YP, Thompson D, Aroian KJ, McQuaid EL, Deatrick JA. Commentary: Writing and Evaluating Qualitative Research Reports. J Pediatr Psychol 2016; 41:493-505. [PMID: 27118271 DOI: 10.1093/jpepsy/jsw032] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 03/25/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To provide an overview of qualitative methods, particularly for reviewers and authors who may be less familiar with qualitative research. METHODS A question and answer format is used to address considerations for writing and evaluating qualitative research. RESULTS AND CONCLUSIONS When producing qualitative research, individuals are encouraged to address the qualitative research considerations raised and to explicitly identify the systematic strategies used to ensure rigor in study design and methods, analysis, and presentation of findings. Increasing capacity for review and publication of qualitative research within pediatric psychology will advance the field's ability to gain a better understanding of the specific needs of pediatric populations, tailor interventions more effectively, and promote optimal health.
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Affiliation(s)
- Yelena P Wu
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Cancer Control and Population Sciences, Huntsman Cancer Institute,
| | - Deborah Thompson
- Department of Pediatrics-Nutrition, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine
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Hartmann WE, Wendt DC, Saftner MA, Marcus J, Momper SL. Advancing community-based research with urban American Indian populations: multidisciplinary perspectives. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2014; 54:72-80. [PMID: 24659391 PMCID: PMC4165816 DOI: 10.1007/s10464-014-9643-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The US has witnessed significant growth among urban American Indian (AI) populations in recent decades, and concerns have been raised that these populations face equal or greater degrees of disadvantage than their reservation counterparts. Surprisingly little urban AI research or community work has been documented in the literature, and even less has been written about the influences of urban settings on community-based work with these populations. Given the deep commitments of community psychology to empowering disadvantaged groups and understanding the impact of contextual factors on the lives of individuals and groups, community psychologists are well suited to fill these gaps in the literature. Toward informing such efforts, this work offers multidisciplinary insights from distinct idiographic accounts of community-based behavioral health research with urban AI populations. Accounts are offered by three researchers and one urban AI community organization staff member, and particular attention is given to issues of community heterogeneity, geography, membership, and collaboration. Each first-person account provides “lessons learned” from the urban context in which the research occurred. Together, these accounts suggest several important areas of consideration in research with urban AIs, some of which also seem relevant to reservation-based work. Finally, the potential role of research as a tool of empowerment for urban AI populations is emphasized, suggesting future research attend to the intersections of identity, sense of community, and empowerment in urban AI populations.
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Saftner MA, Martyn KK, Momper SL. Urban Dwelling American Indian Adolescent Girls' Beliefs Regarding Health Care Access and Trust. JOURNAL OF INDIGENOUS SOCIAL DEVELOPMENT 2014; 3:1-15. [PMID: 25541597 PMCID: PMC4274642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Indigenous people, specifically American Indians (AI), have historically had a greater mistrust of the medical system compared to their White counterparts. The purpose of this paper is to explore the perceptions of AI adolescent girls living in an urban, Midwest area about health care providers, health care systems, and access to health care as related to sexual health care. Using grounded theory methodology, twenty 15-19 year old AI girls participated in talking circles and individual interviews. Two distinct themes emerged related to sexual health care: 1) AI adolescent girls trust their health care providers and the health care system; and 2) Access to health care is critical to practicing safe sex and obtaining information about healthy sexual practices. These findings are unique and may help health care providers and social workers providing care and support to the urban adolescent AI girl.
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Affiliation(s)
- Melissa A Saftner
- Clinical Associate Professor, The University of Minnesota School of Nursing, 308 Harvard Street SE, Minneapolis, MN 55455, USA; ; ;
| | - Kristy K Martyn
- Professor and Assistant Dean of Clinical Advancement, Emory University Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd NE, Atlanta, GA 30322; ; ;
| | - Sandra L Momper
- Assistant Professor, The University of Michigan School of Social Work, 1080 S. University, Ann Arbor, MI 48109; ; ;
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