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Okamoto SK, Okamura KH, Marshall SM, Chin SK, Carson AB, An KJ, Song SD, Saladino PA, Prado G, Kulis SS. Examining implementation determinants of a culturally grounded, school-based prevention curriculum in rural Hawai'i: A test development and validation study. IMPLEMENTATION RESEARCH AND PRACTICE 2024; 5:26334895241262823. [PMID: 39050583 PMCID: PMC11268022 DOI: 10.1177/26334895241262823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Background This study examined the implementation determinants of a culturally grounded, school-based drug prevention curriculum in rural Hawai'i. Test development and validation procedures were used to examine the impact of implementation barriers and facilitators of the curriculum in public or charter middle/intermediate schools on Hawai'i Island. Method A five-phase, mixed-methods approach toward test development and validation was used. These phases included item generation (Phase 1), item refinement and selection (Phase 2), item reduction (Phase 3), reliability testing (Phase 4), and validity testing (Phase 5). Educational administrators, teachers, and staff employed by the Hawai'i State Department of Education (HIDOE) participated in the study. Results Phases 1 and 2 yielded 50 implementation barriers and 27 implementation facilitators that were evaluated by 204 HIDOE administrators, teachers, and staff. Factor analysis of the barrier items indicated a four-factor solution: (1) Innovation Barriers, (2) HIDOE State-Level Barriers, (3) Teacher-Level Barriers, and (4) Administrator-Level Barriers. Mean comparisons indicated that several barrier and facilitator items differentiated teachers from administrators in the sample. Conclusions This study contributes to the implementation measurement literature, specifically in the areas of mental health and substance use. It also highlights the importance of addressing multiple contextual levels in the implementation of culturally focused prevention interventions. Plain Language Summary Title Examining Implementation Barriers and Facilitators for School-Based Prevention in Hawai'i. Plain Language Summary Compared with other major ethnic groups, Native Hawaiian and Pacific Islander (NHPI) youth have substantially higher rates of substance use and higher adverse mental and physical health effects related to their use. Despite these disparities, educational and community-based practitioners have long struggled with implementing and sustaining promising substance use interventions for NHPI youth. This study contributes to our understanding of measuring implementation barriers and facilitators for substance use prevention for NHPI youth in rural school settings. It contributes to the field of health disparities and health equity promotion, by addressing calls for research to understand factors affecting successful implementation of prevention programs. This is critical toward achieving health equity for underrepresented and vulnerable populations, such as NHPI and rural youth.
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Affiliation(s)
- Scott K. Okamoto
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Kelsie H. Okamura
- Implementation Research Division, The Baker Center for Children and Families, Roxbury Crossing, MA, USA
| | - Sarah Momilani Marshall
- Thompson School of Social Work & Public Health, University of Hawai‘i at Mānoa, Honolulu, HI, USA
| | - Steven Keone Chin
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Adabelle B. Carson
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Katlyn J. An
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Sarah D. Song
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | - Paula Angela Saladino
- Population Sciences in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI, USA
| | | | - Stephen S. Kulis
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
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Manglallan KS, Johnson DL, Rosario MH, An KJ, Carson AB, Phillips KT, Pokhrel P, Okamoto SK. A Systematic Literature Review of Asian American, Native Hawaiian, and Pacific Islander Youth Electronic Nicotine Delivery Systems (ENDS) Use. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:151-157. [PMID: 37465472 PMCID: PMC10351245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Rates of electronic nicotine delivery systems (ENDS) use are exponentially increasing in youth and young adults within the United States, including Asian American, Native Hawaiian, and Pacific Islander (AANHPI) youth in Hawai'i. Disproportionately high ENDS use rates for AANHPI youth point to the need to understand the empirical literature in this area. A systematic literature review is a prerequisite for programs effectively curbing AANHPI youths' elevated use of ENDS. This systematic literature review examines empirical studies published between 2010-2020 on ENDS and their use as it applies to AANHPI youth. A total of 11 articles were identified using specific inclusionary and exclusionary criteria in a literature search. Studies described individual and interpersonal correlates to ENDS use. Notably, there were no published ENDS intervention studies detailed to AANHPI youth. Implications of these studies for prevention and social welfare interventions are discussed.
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Affiliation(s)
| | - Dixie L. Johnson
- School of Social Work, Hawai‘i Pacific University, Honolulu, HI (KSM, DLJ, SKO)
| | | | - Katlyn J. An
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
| | - Adabelle B. Carson
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
| | - Kristina T. Phillips
- Center for Integrated Health Care Research (CIHR), Kaiser Permanente Hawai‘i, Honolulu, HI (KTP)
| | - Pallav Pokhrel
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
| | - Scott K. Okamoto
- School of Social Work, Hawai‘i Pacific University, Honolulu, HI (KSM, DLJ, SKO)
- Cancer Prevention in the Pacific Program, University of Hawai‘i Cancer Center, Honolulu, HI (KJA, ABC, PP, SKO)
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3
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Boyd RC, Castro FG, Finigan-Carr N, Okamoto SK, Barlow A, Kim BKE, Lambert S, Lloyd J, Zhang X, Barksdale CL, Crowley DM, Maldonado-Molina M, Obasi EM, Kenney A. Strategic Directions in Preventive Intervention Research to Advance Health Equity. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 24:577-596. [PMID: 36469162 PMCID: PMC9734404 DOI: 10.1007/s11121-022-01462-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2022] [Indexed: 12/09/2022]
Abstract
As commissioned by the Society for Prevention Research, this paper describes and illustrates strategic approaches for reducing health inequities and advancing health equity when adopting an equity-focused approach for applying prevention science evidence-based theory, methodologies, and practices. We introduce an ecosystemic framework as a guide for analyzing, designing, and planning innovative equity-focused evidence-based preventive interventions designed to attain intended health equity outcomes. To advance this process, we introduce a health equity statement for conducting integrative analyses of ecosystemic framework pathways, by describing the role of social determinants, mechanisms, and interventions as factors directly linked to specific health equity outcomes. As background, we present health equity constructs, theories, and research evidence which can inform the design and development of equity-focused intervention approaches. We also describe multi-level interventions that when coordinated can produce synergistic intervention effects across macro, meso, and micro ecological levels. Under this approach, we encourage prevention and implementation scientists to apply and extend these strategic directions in future research to increase our evidence-based knowledge and theory building. A general goal is to apply prevention science knowledge to design, widely disseminate, and implement culturally grounded interventions that incrementally attain specific HE outcomes and an intended HE goal. We conclude with recommendations for conducting equity-focused prevention science research, interventions, and training.
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Affiliation(s)
- Rhonda C Boyd
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | | | | | | | - Allison Barlow
- John Hopkins Center for American Indian Health, Baltimore, MD, USA
| | | | | | - Jacqueline Lloyd
- Office of Disease Prevention, National Institutes of Health, Rockville, MD, USA
| | - Xinzhi Zhang
- National Center for Advancing Translational Sciences, National Institutes of Health, Bethesda, MD, USA
| | - Crystal L Barksdale
- National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | - Anne Kenney
- John Hopkins Center for American Indian Health, Baltimore, MD, USA
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4
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Pham T, Akamu C, Do A, Tomita KK, Combs S. Systems of Care Implications in Hawai'i: Sexual and Gender Minorities. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2022; 81:52-61. [PMID: 36660277 PMCID: PMC9783816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Sexual and gender minorities (SGM) are diverse groups of people who do not identify as heterosexual or cisgender. SGM communities include Lesbian, Gay, Bisexual, and Transgender (LGBT) individuals as well as people of other sexual orientations and gender identities. SGM communities are disproportionately affected by substance use disorders, with differential use of specific substances among persons based on sexual or gender identity. As understood through the minority stress model, substance use and misuse among SGM people are tied to risk and resiliency factors at all levels of the social ecological paradigm. Despite the disproportionate burden of substance use disorders on SGM people in Hawai'i, very few resources or programs exist to ameliorate the impact of substance use on this community. Although some models of care could be useful for SGM people, community-specific interventions are scarce, especially in Hawai'i. To successfully meet the needs of SGM people in Hawai'i, multi-level transformation of the substance use prevention and treatment landscape must address: culturally appropriate service delivery; workforce recruitment and development; nimble and adequate financing; consistent data collection and reporting; and systems-level policy updates.
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Affiliation(s)
- Thaddeus Pham
- Harm Reduction Services Branch, Communicable Disease and Public Health
Nursing, Division, Hawai‘i Department of Health, Honolulu, HI (TP)
- Hep Free Hawai‘i, Honolulu, HI (TP)
| | - Cade Akamu
- Department of Psychiatry, John A Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI (CA)
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI (CA)
| | - Annie Do
- School of Public Health, University of Washington, Seattle, WA (AD)
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Hunter AM, Carlos M, Nuño VL, Tippeconnic‐Fox MJ, Carvajal S, Yuan NP. Native Spirit: Development of a culturally grounded after-school program to promote well-being among American Indian adolescents. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:242-251. [PMID: 35194803 PMCID: PMC9544255 DOI: 10.1002/ajcp.12590] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/04/2022] [Accepted: 01/13/2022] [Indexed: 06/10/2023]
Abstract
Culturally grounded after-school programs (ASPs), based on local cultural values and practices, are often developed and implemented by and for the local community. Culturally grounded programs promote health and well-being for American Indian and Alaska Native (AI/AN) adolescents by allowing them to reconnect to cultural teachings that have faced attempted historical and contemporary erasure. This article is a first-person account that describes the development and implementation of a culturally grounded ASP, Native Spirit (NS), for AI adolescents (grades 7-12) living on a Southwest urban-based reservation. NS, a 13-session culturally grounded ASP, was developed by an academic-community partnership that focuses on increasing cultural engagement as a form of positive youth development. Each session was guided by one to two local cultural practitioners and community leaders. The development of the NS program contributed to an Indigenous prevention science that emphasizes the positive impacts of Indigenous culture and community on health and well-being. The use of the ASP format, in partnership with the Boys & Girls Club, increased the feasibility of dissemination and refinement of the NS program by tribal communities and organizations.
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Affiliation(s)
- Amanda M. Hunter
- Center for Health Equity ResearchNorthern Arizona UniversityFlagstaffArizonaUSA
| | - Mikah Carlos
- Salt River Pima Maricopa Indian CommunityYouth Services DepartmentScottsdaleArizonaUSA
| | - Velia L. Nuño
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
| | - Mary Jo Tippeconnic‐Fox
- Department of American Indian Studies, College of Social & Behavioral SciencesUniversity of ArizonaTucsonArizonaUSA
| | - Scott Carvajal
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
| | - Nicole P. Yuan
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonArizonaUSA
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6
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A Scoping Review of School-Based Prevention Programs for Indigenous Students. EDUCATIONAL PSYCHOLOGY REVIEW 2022. [DOI: 10.1007/s10648-022-09698-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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7
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Huang CY, Nishioka SA, Zane NW, Uchigakiuchi P. Examining risk and protective predictors of substance use among low-income Native Hawaiian and Pacific Islander adolescents. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2021; 92:18-24. [PMID: 34516146 PMCID: PMC8831443 DOI: 10.1037/ort0000582] [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] [Indexed: 11/08/2022]
Abstract
Substance use (SU) among adolescents is a critical public health concern that increases the risk for negative outcomes. Although Asian American (AA) adolescents tend to report low rates of SU, Native Hawaiian and Pacific Islander (NH/PI) adolescents often report significantly higher rates of use. Yet, NH/PI youth are seldom studied as a separate group. Consequently, little is known about the factors involved in SU among NH/PI adolescents and how to prevent it. This prospective study investigated the effect of ecological risk and protective factors at the individual, family, and school levels on SU for NH/PI adolescents. This prospective study utilized longitudinal data from 120 NH/PI adolescents who were7 part of an SU prevention program. Information was collected at two time points-Time 1 and Time 2 (32 weeks later)-and included adolescents' SU behaviors and individual, family, and school factors. The parents of these adolescents also provided data; all information was self-report. Positive academic attitudes at Time 1 were negatively associated with alcohol and other drug (e.g., marijuana) use at Time 2. Specifically, NH/PI adolescents who had more positive attitudes toward their school, peers, and teachers reported less alcohol and other SU. Prevention efforts may be most effective for NH/PI adolescents if addressed within the school context. This may include programs implemented in schools, utilizing teachers as role models, and/or promoting prosocial peer relationships to support positive behaviors. Additional implications are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Cindy Y. Huang
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Silvia A. Nishioka
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | - Nolan W. Zane
- Department of Psychology, Asian American Center on Disparities Research, University of California, Davis
| | - Patrick Uchigakiuchi
- Social Science Research Institute, College of Social Sciences, University of Hawaii at Manoa
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8
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Maina G, Mclean M, Mcharo S, Kennedy M, Djiometio J, King A. A scoping review of school-based indigenous substance use prevention in preteens (7-13 years). Subst Abuse Treat Prev Policy 2020; 15:74. [PMID: 32998753 PMCID: PMC7528230 DOI: 10.1186/s13011-020-00314-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Early-onset substance use is a risk factor for continued use, dependency, and poor long-term health outcomes. Indigenous youth are more likely to engage in early-onset substance use than their non-Indigenous counterparts. In Canada, culturally appropriate prevention programs are needed for Indigenous youth in elementary schools. Therefore, this scoping review aims to explore the published, international literature examining school-based substance use prevention programs for Indigenous children aged 7-13. MAIN TEXT Methods: This scoping review followed a six-step approach: 1) identifying the research questions, 2) identifying relevant studies, 3) selecting the studies, 4) charting the data, 5) collating, summarizing, and reporting the results, and 6) consulting with experts. The review was reported using guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses extensions for Scoping Reviews (PRISMA-ScR). RESULTS Eleven articles (3 Canadian; 7 American and; 1 Australian) were included in the review. The prevention programs they studied were based on existing research or were adapted from existing interventions. The programs were tailored to each communities' culture by including Indigenous stakeholders in developing or adapting prevention programs to be culturally safe and responsive. The articles evaluated the programs' Effectiveness in changing student knowledge, attitudes, and behaviors using pre- and post-intervention surveys, randomized control trials, longitudinally designed analysis, and mixed methods. Mixed quantitative findings and qualitative findings highlighted the programs' value in building community capacity and fostering cultural revitalization. CONCLUSION This review highlights best practices for developing school-based substance use prevention programs for Indigenous youth. Findings suggest that prevention programs should be culturally responsive and provide students with the knowledge and skills to prevent and manage substance use in real-life situations. Making Indigenous beliefs, values, languages, images, and worldviews central to the prevention curriculum enhanced the Effectiveness, appropriateness, and sustainability of prevention programs. Indigenous communities are best positioned to facilitate cultural tailoring without compromising the fidelity of evidence-based prevention programs.
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Affiliation(s)
- Geoffrey Maina
- College of Nursing, University of Saskatchewan, 210-1301 Central Avenue, Prince Albert, S5V 4W1 S.K, Canada.
| | - Maeve Mclean
- Master of Public Health, University of Saskatchewan, Saskatoon, Canada
| | - Solomon Mcharo
- College of Nursing, University of Saskatchewan, Saskatoon Campus, Saskatoon, Canada
| | - Megan Kennedy
- Librarian- Library, and Museums - Public Services 2, University of Alberta, Edmonton, Canada
| | - Joseph Djiometio
- Daphne Cockwell School of Nursing, Faculty of Community Services, Ryerson University, Toronto, Canada
| | - Alexandra King
- Cameco Chair in Indigenous Health, University of Saskatchewan, Saskatoon, Canada
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9
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Deep-Structure Adaptations and Culturally Grounded Prevention Interventions for Native Hawaiians: a Systematic Review of the Literature. J Racial Ethn Health Disparities 2020; 8:570-578. [PMID: 32666508 DOI: 10.1007/s40615-020-00815-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 10/23/2022]
Abstract
Research has shown that Native Hawaiians disproportionately suffer from behavioral disorders and chronic physical diseases, yet they have historically lacked effective and culturally relevant prevention interventions to address their pervasive health disparities. This article systematically reviewed the recent culturally relevant prevention intervention literature focused on Native Hawaiians. In this review, we assessed 14 peer-reviewed articles published between 2015 and 2020 that met inclusion and exclusion criteria pertaining to the development and/or evaluation of prevention interventions for Native Hawaiians. The reviewed studies evaluated ten different interventions that were developed using deep-structure adaptation or culturally grounded procedures, and primarily focused on prevention of substance use, obesity/diabetes, and pregnancy/sexually transmitted infections (STIs). Compared with the prior related literature reviews, the present review suggests an overall advancement in prevention science for Native Hawaiians, evidenced by an increase in federal funding and randomized controlled clinical trials of prevention interventions for the population. This review provides an update to the state of the science for Native Hawaiian prevention interventions and points to areas of future research and development.
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10
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Okamoto SK, Helm S, Chin SK, Hata J, Hata E, Okamura KH. The implementation of a culturally grounded, school-based, drug prevention curriculum in rural Hawai'i. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:1085-1099. [PMID: 31332808 PMCID: PMC6980923 DOI: 10.1002/jcop.22222] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/21/2019] [Accepted: 06/18/2019] [Indexed: 06/10/2023]
Abstract
This article describes the process of infusing implementation strategies in the development of a school-based drug prevention curriculum for rural Native Hawaiian youth. The curriculum (Ho'ouna Pono) is a video-enhanced, teacher-implemented curriculum developed using a culturally grounded and community-based participatory research approach. Throughout the development of the curriculum, strategies reflective of the domains of the Consolidated Framework for Implementation Research (CFIR) were integrated into the teacher training manual, to promote the implementation, adoption, and sustainability of the curriculum in rural Hawai'i. These strategies were validated through qualitative data across two interrelated studies with community stakeholders in rural Hawai'i. Implications for prevention, community, and educational practices are described in this article.
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Affiliation(s)
- Scott K Okamoto
- College of Health & Society, School of Social Work, Hawai'i Pacific University, Honolulu, Hawai'i
| | - Susana Helm
- Department of Psychiatry, University of Hawai'i at Mānoa, Honolulu, Hawai'i
| | - Steven K Chin
- College of Health & Society, School of Social Work, Hawai'i Pacific University, Honolulu, Hawai'i
| | - Janice Hata
- College of Health & Society, School of Social Work, Hawai'i Pacific University, Honolulu, Hawai'i
| | - Emily Hata
- College of Health & Society, School of Social Work, Hawai'i Pacific University, Honolulu, Hawai'i
| | - Kelsie H Okamura
- Child and Adolescent Mental Health Division, State of Hawai'i Department of Health, Honolulu, Hawai'i
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Isler J, Sawadogo NH, Harling G, Bärnighausen T, Adam M, Kagoné M, Sié A, Greuel M, McMahon SA. Iterative Adaptation of a Mobile Nutrition Video-Based Intervention Across Countries Using Human-Centered Design: Qualitative Study. JMIR Mhealth Uhealth 2019; 7:e13604. [PMID: 31710302 PMCID: PMC6878105 DOI: 10.2196/13604] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/29/2019] [Accepted: 07/27/2019] [Indexed: 11/16/2022] Open
Abstract
Background Mobile health (mHealth) video interventions are often transferred across settings. Although the outcomes of these transferred interventions are frequently published, the process of adapting such videos is less described, particularly within and across lower-income contexts. This study fills a gap in the literature by outlining experiences and priorities adapting a suite of South African maternal nutrition videos to the context of rural Burkina Faso. Objective The objective of this study was to determine the key components in adapting a suite of maternal nutrition mHealth videos across settings. Methods Guided by the principles of human-centered design, this qualitative study included 10 focus group discussions, 30 in-depth interviews, and 30 observations. We first used focus group discussions to capture insights on local nutrition and impressions of the original (South African) videos. After making rapid adjustments based on these focus group discussions, we used additional methods (focus group discussions, in-depth interviews, and observations) to identify challenges, essential video refinements, and preferences in terms of content delivery. All data were collected in French or Dioula, recorded, transcribed, and translated as necessary into French before being thematically coded by two authors. Results We propose a 3-pronged Video Adaptation Framework that places the aim of video adaptation at the center of a triangle framed by end recipients, health workers, and the environment. End recipients (here, pregnant or lactating mothers) directed us to (1) align the appearance, priorities, and practices of the video’s protagonist to those of Burkinabe women; (2) be mindful of local realities whether economic, health-related, or educational; and (3) identify and routinely reiterate key points throughout videos and via reminder cards. Health workers (here, Community Health Workers and Mentor Mothers delivering the videos) guided us to (1) improve technology training, (2) simplify language and images, and (3) increase the frequency of their engagements with end recipients. In terms of the environment, respondents guided us to localize climate, vegetation, diction, and how foods are depicted. Conclusions Design research provided valuable insights in terms of developing a framework for video adaptation across settings, which other interventionists and scholars can use to guide adaptations of similar interventions.
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Affiliation(s)
- Jasmin Isler
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | | | - Guy Harling
- Institute for Global Health, University College London, London, United Kingdom.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States.,Harvard Center for Population & Development Studies, Harvard University, Cambridge, MA, United States.,Africa Health Research Institute, KwaZulu-Natal, South Africa.,MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, United States.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Maya Adam
- Stanford Center for Health Education, Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | | | - Ali Sié
- Nouna Health Research Center, Nouna, Nouna, Burkina Faso
| | - Merlin Greuel
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Shannon A McMahon
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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12
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Wills TA, Okamoto SK, Knight R, Pagano I. Parental Support, Parent-Adolescent Conflict, and Substance Use of Native Hawaiian and Other Pacific Islander Youth: Ethnic Differences in Stress-Buffering and Vulnerability Effects. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2019; 10:218-226. [PMID: 31788156 PMCID: PMC6884318 DOI: 10.1037/aap0000139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This research study examined the overall and ethnic-specific effects of parental emotional and instrumental support, parent-adolescent interpersonal conflict, and negative life events (i.e., major life stressors, such as parental job loss or school suspension) on the substance use of Caucasian, Asian-American, Filipino, and Native Hawaiian and other Pacific Islander (NHOPI) youth in Hawai'i. Adolescents (N = 3,561) from 10 public middle/intermediate schools completed paper/pencil surveys, and multiple regression and structural equation models were developed to examine overall and ethnic-specific effects. Parental support was found to buffer against the influence of negative life events on substance use in the overall sample; however, this effect was not observed for either Caucasian or NHOPI youth in ethnic-specific analyses. The impact of parent-adolescent conflict and negative life events on substance use was more pronounced for both Filipino and NHOPI youth. While the study may have had some limitations related to regional specificity and measurement, the findings nonetheless point to the differential effects of risk and protective factors for NHOPI youth, compared with other youth ethnic groups in Hawai'i. Implications of these findings for culturally specific, family-focused prevention research and practice for NHOPI youth are discussed.
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Affiliation(s)
- Thomas A Wills
- Professor and Director of the Cancer Prevention in the Pacific Program, University of Hawai'i Cancer Center
| | - Scott K Okamoto
- Professor and Research Faculty, School of Social Work, Hawai'i Pacific University, and an Adjunct Associate Researcher, Cancer Prevention in the Pacific Program, University of Hawai'i Cancer Center
| | - Rebecca Knight
- Community Health Educator, Polk County Public Health, Polk County, OR
| | - Ian Pagano
- Assistant Professor, Cancer Prevention in the Pacific Program, University of Hawai'i Cancer Center
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13
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Helm S, Hishinuma E, Okamoto S, Chin SK, Silva A. The Relationship Between Ethnocultural Identity Measures and Youth Substance Use Among a School-Based Sample: A Focus on Native Hawaiian Youth. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2019; 10:206-217. [PMID: 32983371 PMCID: PMC7517588 DOI: 10.1037/aap0000157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The way in which behavioral health interventions are designed, implemented, and evaluated must be responsive to the ethnocultural characteristics of the targeted youth and their families, schools, and communities. The goal of this paper is to examine the relationship between ethnocultural identity measures and substance use among Native Hawaiian compared to non-Hawaiian youth. A cross-sectional analysis was conducted from baseline data drawn from an efficacy trial of a culturally-grounded drug prevention curriculum, Hoòuna Pono. The sample (N=486) included youth from 13 rural, public middle schools who identified as Native Hawaiian, as well as other Pacific Islander, Asian, and other ethnicities. Ethnocultural identity measures used to explore the relationship between 30-day substance use included items from the Hawaiian Culture Scale (Hishinuma et al., 2000) and from Phinney's (1992) Multigroup Ethnic Identity Measure. Among the total sample, prevalence rates indicated that 11.2% of participants reported having been offered substances, and 9.7% reported having used one or more substances in the past month. For Hawaiian youth relative to the non-Hawaiian group, higher levels of Native Hawaiian ethnocultural independent variables were moderately associated with fewer offers to use substances and less gateway drug use. Other results were mixed regarding the relationship between ethnocultural variables and substance use. The present study found that selected ethnocultural variables were moderately associated with fewer drug offers and lower levels of gateway drug use for Hawaiian versus non-Hawaiian youth.
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Affiliation(s)
- Susana Helm
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai'i at Mānoa
| | - Earl Hishinuma
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawai'i at Mānoa
| | - Scott Okamoto
- School of Social Work, Hawai'i Pacific University, and an Adjunct Professor, John A. Burns School of Medicine, University of Hawai'i at Mānoa
| | | | - Anjelica Silva
- Post-baccalaureate Research Assistant, John A. Burns School of Medicine, University of Hawai'i at Mānoa
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Okamoto SK, Kulis SS, Helm S, Chin SK, Hata J, Hata E, Lee A. An Efficacy Trial of the Ho'ouna Pono Drug Prevention Curriculum: An Evaluation of a Culturally Grounded Substance Abuse Prevention Program in Rural Hawai'i. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2019; 10:239-248. [PMID: 32395199 PMCID: PMC7213509 DOI: 10.1037/aap0000164] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This study reports on the drug use outcomes in an efficacy trial of a culturally grounded, school-based, substance abuse prevention curriculum in rural Hawai'i. The curriculum (Ho'ouna Pono) was developed through a series of pre-prevention and pilot/feasibility studies funded by the National Institute on Drug Abuse, and focuses on culturally relevant drug resistance skills training. The present study used a dynamic wait-listed control group design (Brown, Wyman, Guo, & Pena, 2006), in which cohorts of middle/intermediate public schools on Hawai'i Island were exposed to the curriculum at different time periods over a two-year time frame. Four-hundred and eighty six youth participated in the study. Approximately 90% of these youth were 11 or 12 years of age at the start of the trial. Growth curve modeling over six waves of data was conducted for alcohol, marijuana, cigarettes/e-cigarettes, crystal methamphetamine, and other hard drugs. The findings for alcohol use were contrary to the hypothesized effects of the intervention, but may have been a reflection of a lack equivalence among the cohorts in risk factors that were unaccounted for in the study. Despite this issue, the findings also indicated small, statistically significant changes in the intended direction for cigarette/e-cigarette and hard drug use. The present study compliments prior pilot research on the curriculum, and has implications for addressing Native Hawaiian and Pacific Islander health disparities.
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Rasmus SM, Charles B, John S, Allen J. With a Spirit that Understands: Reflections on a Long-term Community Science Initiative to End Suicide in Alaska. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:34-45. [PMID: 31343758 PMCID: PMC6750997 DOI: 10.1002/ajcp.12356] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This retrospective analysis of a long-term community-based participatory research (CBPR) process spans over two decades of work with Alaska Native communities. A call to action from Alaska Native leadership to create more effective strategies to prevent and treat youth suicide and alcohol misuse risk initiated a response from university researchers. This CBPR process transformed into a collaborative effort to indigenously drive and develop solutions through research. The People Awakening project started our team on this translational and transformational pathway through community intervention science in the Central Yup'ik region of Alaska. We examine more deeply the major episodes and their successes and struggles in maintaining a long-term research relationship between university researchers and members of Yup'ik Alaska Native communities. We explore ways that our CBPR relationship has involved negotiation and engagement with power and praxis, to deepen and focus attention to knowledge systems and relational elements. This paper examines these deeper, transformative elements of our CBPR relationship that spans histories, cultures, and systems. Our discussion shares vignettes from academic and community perspectives to describe process in a unique collaboration, reaching to sometimes touch upon rare ground in emotions, tensions, and triumphs over the course of a dozen grants and twice as many years. We conclude by noting how there are points where, in a long-term CBPR relationship, transition out of emergence into coalescing and transformation can occur.
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Affiliation(s)
- Stacy M. Rasmus
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, 205 Arctic Health Research Building, 2141 Koyukuk Drive, PO Box 757000, 99775-7000
| | - Billy Charles
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, 205 Arctic Health Research Building, 2141 Koyukuk Drive, PO Box 757000, 99775-7000
| | - Simeon John
- Center for Alaska Native Health Research, Institute for Arctic Biology, University of Alaska Fairbanks, 205 Arctic Health Research Building, 2141 Koyukuk Drive, PO Box 757000, 99775-7000
| | - James Allen
- Department of Family Medicine and Biobehavioral Health & Memory Keepers Medical Discovery Team - American Indian and Rural Health Equity, University of Minnesota Medical School, Duluth Campus, 624 E. 1st St., Suite 201, Duluth, MN 55805
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Subica AM, Aitaoto N, Link BG, Yamada AM, Henwood BF, Sullivan G. Mental Health Status, Need, and Unmet Need for Mental Health Services Among U.S. Pacific Islanders. Psychiatr Serv 2019; 70:578-585. [PMID: 30991907 PMCID: PMC6602838 DOI: 10.1176/appi.ps.201800455] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE This study examined the mental health status, need for services, and unmet need of community-dwelling Native Hawaiian and other Pacific Islanders (NHPI). METHODS Survey data were collected from 223 NHPI adults of Samoan or Marshallese heritage. Surveys were translated into Samoan and Marshallese by using back-translation, with feedback from cultural experts. Severity of depression, anxiety, and alcohol use were measured, as were perceived need for and avoidance of, or delay in, seeking mental health services. Logistic regressions calculated adjusted odds ratios for past-year perceived need for services and avoidance or delay of needed services, controlling for depression, anxiety, and alcohol use. RESULTS Participants' screened prevalence of major depression, generalized anxiety disorder, and alcohol use disorder was 21%, 12%, and 22%, respectively. In the past year, 35% and 26% of participants reported needing services and avoiding or delaying needed services, respectively. Urban Samoan and rural Marshallese participants did not differ significantly in measures of depression, anxiety, or alcohol use, even though the groups had significant demographic differences. Female gender and greater familiarity-contact with persons with mental illness were significant predictors of both reporting service need and reporting avoiding or delaying services. CONCLUSIONS Community-dwelling NHPIs reported a heavy burden of depression, anxiety, and alcohol use, and high perceived need for services, yet low levels of help-seeking. The large unmet need in the sample suggests that a gap may exist between service need and engagement in U.S. NHPI communities that could be targeted with culturally tailored approaches that promote engagement in care.
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Affiliation(s)
- Andrew M. Subica
- University of California, Riverside Center for Healthy Communities, School of Medicine
| | | | - Bruce G. Link
- University of California, Riverside School of Public Policy
| | - Ann Marie Yamada
- University of Southern California, USC Suzanne Dworak-Peck School of Social Work
| | - Benjamin F. Henwood
- University of Southern California, USC Suzanne Dworak-Peck School of Social Work
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Helm S, Okamoto SK. Gendered Perceptions of Drugs, Aggression, and Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2019; 34:2292-2312. [PMID: 27456534 PMCID: PMC5266725 DOI: 10.1177/0886260516660301] [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] [Indexed: 06/06/2023]
Abstract
Drug use has been linked empirically with aggression and violence among youth in national and State of Hawai'i samples. In addition, aggression and violence appear to be gendered experiences perceived differently by girls and boys. This article explores the intersection of drug offers/drug refusals with aggression and violence with specific attention paid to gendered perceptions of drug use situations as a context for aggression and violence. A qualitative study, in which 14 sex-specific focus group discussions were held, focused on rural Native Hawaiian middle school students ( N = 64). Students were asked to discuss drug refusal strategies in a variety of drug offer contexts. Feminist theories and approaches were used to examine the role of aggression and violence in drug refusal as perceived by Native Hawaiian girls as compared with boys. Girls and boys differed in their perceptions of aggression and violence in drug offer situations, initially as evidenced by the extent to which the girl groups focused on the intersection of drugs and violence. Furthermore, qualitative analyses reflected gender norms and stereotypes about aggression and violence perpetration, and girls' apparently unique concerns about sexual violence victimization. Implications are discussed in terms of prevention research and practice, specifically in terms of school-based prevention curricula.
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Affiliation(s)
- Susana Helm
- 1 University of Hawai'i at Mānoa, Honolulu, HI, USA
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Okamoto SK, Helm S, Ostrowski LK, Flood L. The Validation of a School-Based, Culturally Grounded Drug Prevention Curriculum for Rural Hawaiian Youth. Health Promot Pract 2018; 19:369-376. [PMID: 28443350 PMCID: PMC5623612 DOI: 10.1177/1524839917704210] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to validate a school-based, culturally grounded drug prevention curriculum for rural Native Hawaiian youth. Faculty and administrators from eight geographically dispersed middle-, intermediate-, or multilevel schools on Hawai'i island were interviewed on the cultural relevance and feasibility of implementation of the curriculum (Ho'ouna Pono). While all participants appreciated the culturally specific content interwoven throughout the curriculum's structure, several of them expressed concerns that the curriculum would compete with resources needed to implement Common Core national standards. Implications for the implementation, adoption, and sustainability of school-based prevention curricula are discussed.
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Affiliation(s)
| | - Susana Helm
- 2 University of Hawai'i at Mānoa, Honolulu, HI, USA
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Jenkins EK, Slemon A, Haines-Saah RJ. Developing harm reduction in the context of youth substance use: insights from a multi-site qualitative analysis of young people's harm minimization strategies. Harm Reduct J 2017; 14:53. [PMID: 28760146 PMCID: PMC5537985 DOI: 10.1186/s12954-017-0180-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 07/25/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Youth substance use programming and educational strategies are frequently informed by prevention approaches that emphasize abstinence goals, which often do not resonate with youth in their lack of acknowledgment of young people's social context and how young people perceive positive effects of substance use. Further, approaches to drug prevention have been critiqued as adopting a one-size-fits-all approach and therefore inadequate in addressing substance use in the context of population variation and inequities. In response to the limitations of current approaches to prevention, programming informed by harm reduction principles that aims to minimize harms without requiring abstinence is emergent in school settings. However, youth perspectives informing harm reduction are limited in both research and program development. METHODS This paper draws on data from the Researching Adolescent Distress and Resilience (RADAR) study, which utilized an ethnographic approach to bring youth voice to the literature on mental health and substance use. Qualitative data collection included individual interviews (n = 86) with young people aged 13-18 across three communities-representing urban, suburban, and rural geographies-in British Columbia, Canada. A multi-site qualitative analysis of interview data was conducted to identify themes across and within each research site. RESULTS Across all three sites, young people's individual experiences of substance use were shaped by geographic, socio-cultural, and political contexts, with youth describing their use in relation to the nature of substance use in peer groups and in the broader community. To manage their own substance use and reduce related harms, youth employed a variety of ad hoc harm minimization strategies that were reflective of their respective contexts. CONCLUSIONS The findings from this study suggest the importance of harm reduction approaches that are contextually relevant and responsive to the lived experiences of youth. Youth perspectives in the development of harm reduction programming are needed to ensure that approaches are relatable and meaningful to young people, and effective for promoting the minimization of substance-related harms.
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Affiliation(s)
- Emily K. Jenkins
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Allie Slemon
- School of Nursing, University of British Columbia, T201-2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Rebecca J. Haines-Saah
- Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4 Canada
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Liddell J, Burnette CE. Culturally-Informed Interventions for Substance Abuse Among Indigenous Youth in the United States: A Review. ACTA ACUST UNITED AC 2017. [PMID: 28628397 DOI: 10.1080/23761407.2017.1335631] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Given the disproportionately high levels of alcohol and other drug abuse among Indigenous youth in the United States, the purpose of this systematic review was to explicate the current state of empirically-based and culturally-informed substance abuse prevention and intervention programs for Indigenous youth (ages 9-18). METHOD The 14 articles that met inclusion criteria for this review were analyzed both in terms of the cultural intervention itself (primary population, intervention, core tenants, focus of intervention, intervention goals, location, intervention location, and program length) and their evaluation approach. RESULTS Results indicate variable integration of cultural components with the majority of interventions taking place in schools and treatment facilities, targeting primarily individuals. DISCUSSION There is a current gap in research on culturally-informed substance abuse interventions for Indigenous youth, which this review begins to address. Promising areas of future research and interventions include bringing communities and families into treatment and prevention.
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Affiliation(s)
- Jessica Liddell
- a School of Social Work , Tulane University , New Orleans , Louisiana , USA
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Bills K, Okamoto SK, Helm S. The Role of Relational Harmony in the Use of Drug-Refusal Strategies of Rural Native Hawaiian Youths. JOURNAL OF ETHNIC & CULTURAL DIVERSITY IN SOCIAL WORK 2016; 25:208-226. [PMID: 28133439 PMCID: PMC5267551 DOI: 10.1080/15313204.2016.1146190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the role of maintaining relational harmony among family members in the use of drug refusal strategies for rural Hawaiian youth. Youth focus groups were conducted to validate refusal strategies used in realistic, hypothetical drug-related problem situations. The findings suggested gender-specific motivations for maintaining relational harmony among family members when faced with drug offers from them. Specifically, boys described instrumental concerns when using refusal strategies (i.e., not wanting to get into trouble), while girls described holistic relational concerns (i.e., not wanting family members to be upset with each other). Implications for prevention and social work practice are discussed.
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