1
|
Donald C, Rajani K, Singer M, Skye M, Craig Rushing S, Kelley A, Morgan B, Zaback T, Becker T, Lambert W. A Qualitative Review of Barriers and Facilitators Identified While Implementing the Native Students Together Against Negative Decisions Curriculum in a Multisite Dissemination and Implementation Study. HEALTH EDUCATION & BEHAVIOR 2024; 51:425-435. [PMID: 36124442 DOI: 10.1177/10901981221123228] [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] [Indexed: 11/16/2022]
Abstract
Culturally-adapted evidence-based programs (EBPs) are needed to promote healthy behaviors among Native teens and young adults. Little is known about the facilitators and barriers of implementing and sustaining EBPs in Native communities. This paper aims to identify those factors described by educators who implemented the Native Students Together Against Negative Decisions (STAND) curriculum. METHODS We conducted qualitative, semi-structured interviews with 44 Native STAND educators from 48 sites throughout the United States. We used a modified grounded theory approach to explore barriers, facilitators, and sustainability factors related to implementing Native STAND. RESULTS We learned that disruptions to staffing, coordination, and organizational factors were the most common barriers. Factors that improved implementation success included: tailoring the program to local needs/constraints, having a supportive Project Manager, improved fidelity due to check-in calls, and participation in summer training. Factors that improved sustainability included: access to needed infrastructure, administrative support, community support, and student interest. DISCUSSION The delivery of Native STAND was further improved by person-to-person communication and resource sharing across sites. Sustaining EBPs in AI/AN settings requires culturally-tailored technical assistance, sufficient implementation funds for materials and staffing, and a community of peer educators to inspire forward progress. CONCLUSION EBPs that reflect the needs and experiences of American Indian and Alaska Native (AI/AN) youth are necessary to address systemic inequities in adolescent health outcomes. The Native STAND Dissemination and Implementation study is among the first to assess facilitators and barriers to program delivery in diverse AI/AN settings.
Collapse
Affiliation(s)
| | - Kavita Rajani
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Michelle Singer
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Megan Skye
- Oregon Health & Science University, Portland, OR, USA
| | | | | | - Brittany Morgan
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Tosha Zaback
- Oregon Health & Science University, Portland, OR, USA
| | - Thomas Becker
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | | |
Collapse
|
2
|
Stotz SA, Moore KR, McNulty M, Begay K, Scarton L, Jiang L, Adedoyin I, Brega AG. Evaluation of a Synchronous, Online Diabetes Nutrition Education Program for American Indians and Alaska Natives With Type 2 Diabetes: Facilitators and Participants' Experiences. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:114-124. [PMID: 36764793 DOI: 10.1016/j.jneb.2022.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/03/2022] [Accepted: 10/31/2022] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To explore the overall experiences of key players involved in a culturally adapted, online, synchronous diabetes nutrition education program across 5 reservation tribal and intertribal urban Indian clinics. METHODS A multimethods design, including postclass surveys with Likert-scale and short-answer questions, was completed after each of the 5 classes. Participants (n = 54) and class facilitators/coordinators (n = 10) completed postclass surveys (n = 189 and 58, respectively). A subset of participants (n = 24) and all class facilitators/coordinators (n = 10) engaged in online focus groups after the conclusion of program implementation. Qualitative thematic methods and frequency distributions were used to analyze the data. RESULTS Most participants reported that the classes were enjoyable (94%), culturally respectful (77%), and easily accessed online (68%). Qualitative themes included (1) class satisfaction, (2) class improvements, (3) preference for class facilitator, and (4) recommendations to improve recruitment and retention. CONCLUSIONS AND IMPLICATIONS These findings will guide program modifications to provide improved diabetes nutrition education for American Indians and Alaska Natives adults with type 2 diabetes.
Collapse
Affiliation(s)
- Sarah A Stotz
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO.
| | - Kelly R Moore
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Monica McNulty
- University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Kelli Begay
- Maven Collective Consulting, Albuquerque, NM
| | - Lisa Scarton
- College of Nursing, University of Florida, Gainesville, FL
| | - Luohua Jiang
- Department of Epidemiology and Biostatistics, Susan and Henry Samueli College of Health Sciences, University of California Irvine, Irvine, CA
| | | | - Angela G Brega
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| |
Collapse
|
3
|
Feng L, Lv X, Wang Y, Chu S, Dai Z, Jing H, Tong Z, Liao X, Liang L. Developments in smoking cessation interventions for patients with chronic obstructive pulmonary disease in the past 5 years: a scoping review. Expert Rev Respir Med 2022; 16:749-764. [PMID: 35916493 DOI: 10.1080/17476348.2022.2108797] [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: 11/04/2022]
Abstract
INTRODUCTION Smoking cessation is the most effective strategy for slowing the progression of chronic obstructive pulmonary disease (COPD). However, COPD patients find it difficult to quit smoking with standard cessation interventions. AREAS COVERED A scoping review of smoking cessation for COPD patients was conducted by searching the MEDLINE, Embase, and Cochrane Library databases for all studies published between 1 January 2016 and 22 September 2021. Four themes were set up and 47 studies were included eventually. The majority of the included studies (61.7%, 29/47) investigated efficacy and effectiveness, including new strategies for extended treatment and mobile health (mHealth) delivery approach. Studies examining accessibility and utilization (31.9%, 15/47), safety (10.6%, 5/47), and health economics (6.4%, 3/47) were also reviewed. The quality of the included randomized controlled trials was also evaluated. EXPERT OPINION Pharmacotherapy combined with behavioral interventions delivered via mHealth may be a promising strategy to help COPD smokers quit. However, the overall quality of the current studies is poor, making it challenging for clinicians to make informed decisions. Future high-quality studies are needed to provide conclusive evidence on the optimal pharmacotherapies and the most cost-effective comprehensive smoking cessation interventions, particularly those integrated into disease management for smokers with COPD.
Collapse
Affiliation(s)
- Lin Feng
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xiaoshuang Lv
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yingquan Wang
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Shuilian Chu
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zeqi Dai
- Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100010, China
| | - Hang Jing
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Zhaohui Tong
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xing Liao
- Center for Evidence Based Chinese Medicine, Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, 100010, China
| | - Lirong Liang
- Department of Research on Tobacco Dependence Therapies, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
4
|
Leston J, Wenger H, Reilley B, Craig Rushing S, Rink E, Warren H, Howe J, Bloomquist P, Tah T, Jeffries I, Iralu J, Thorpe P, Apostolou A, Taylor MM. Creating a path forward: understanding the context of sexual health and sexually transmitted infections in American Indian/Alaska Native populations – a review. Sex Health 2022; 19:286-298. [PMID: 35760766 PMCID: PMC11081199 DOI: 10.1071/sh22040] [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: 03/04/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022]
Abstract
This review assessed sexual health and sexually transmitted infection (STI) burden among American Indian/Alaska Native (AI/AN) peoples within the context of current clinical and public health services. We conducted a review of published literature about sexual health and bacterial STIs among AI/AN populations in the United States using Medline (OVID), CINAHL (EbscoHost) and Scopus. Peer-reviewed journals published during 1 January 2005-2 December 2021 were included and supplemented by other publicly available literature. A total of 138 articles from reference lists met inclusion criteria, including 85 peer-review articles and 53 additional references. Results indicate a disproportionate burden of STIs is carried by AI/AN populations compared to non-Hispanic Whites. Risk for STIs in AI/AN people has origins in historical trauma and structural and social determinants of health. STI services are available for AI/AN populations, but many barriers to care exist. Community-based sexual health programming has been successful, but has thus far focused primarily on adolescents and young adults. A myriad of factors contributes to high rates of STIs among AI/AN populations. Longstanding disparities show a clear need to increase the availability of integrated, low-barrier STI prevention and treatment services. Implementation of multi-level (individual, physician, clinic, healthcare organisation, and/or community level), culturally relevant sexual health and STI interventions should be community-based and person-centred, acknowledge social determinants of health, and grounded in deep respect and understanding of AI/AN histories and cultures.
Collapse
Affiliation(s)
- Jessica Leston
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | | | - Brigg Reilley
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | | | | | - Hannah Warren
- Alaska Native Tribal Health Consortium, Anchorage, AK, USA
| | - Jean Howe
- Northern Navajo Medical Center, Indian Health Service, Shiprock, NM, USA
| | | | - Tina Tah
- Indian Health Service Headquarters, Rockville, MD, USA
| | - Itai Jeffries
- Northwest Portland Area Indian Health Board, Portland, OR, USA
| | - Jonathan Iralu
- Gallup Indian Medical Center, Indian Health Service, Gallup, NM, USA
| | - Phoebe Thorpe
- U.S. Centers for Disease Control and Prevention, Division of STD Prevention, Atlanta, GA, USA
| | | | - Melanie M. Taylor
- U.S. Centers for Disease Control and Prevention, Division of HIV Prevention, Atlanta, GA, USA
| |
Collapse
|
5
|
Sacca L, Markham C, Hernandez B, Shegog R, Peskin M, Craig Rushing S, Warren H, Tsosie M. The Impact of COVID-19 on the Delivery of Educational Programs in Native American Communities: Qualitative Study. JMIR Form Res 2022; 6:e32325. [PMID: 35348464 PMCID: PMC9004623 DOI: 10.2196/32325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 03/02/2022] [Accepted: 03/18/2022] [Indexed: 11/24/2022] Open
Abstract
Background Despite the availability of culturally responsive sexual health educational programs for American Indian and Alaska Native (AI/AN) youth, barriers to their uptake and utilization persist in tribal communities. These challenges were exacerbated by the COVID-19 pandemic, which required flexible program delivery using both in-person and virtual classrooms. Objective This exploratory study provides a preliminary understanding of the extent to which pre-existing challenges impact the delivery of culturally responsive sexual health education programs in Native communities and to what extent they were exacerbated by the COVID-19 pandemic. It also highlights the challenges faced by adolescent health advocates when adapting culturally responsive health curricula to online platforms. Finally, this study discloses major socioeconomic, health, and mental challenges experienced by AI/AN youth during the pandemic. Methods An exploratory, descriptive, qualitative design approach was adopted to carry out 5 individual and 1 collective in-depth key informant interviews. A total of 8 Native and non-Native sexual health educators served as key informants and shared their personal experiences with the delivery of sexual health education programs for youth during the COVID-19 pandemic. The interviews were conducted virtually from October to November 2020 using Zoom to reach participants dispersed across different regions of the United States. We followed the consolidated criteria for reporting qualitative research (COREQ) as a reference for the study methodology. We also used the Braun and Clarke framework (2006) to conduct a thematic analysis. Results Experts’ opinions were structured according to 5 main themes: (1) competing community priorities during COVID-19; (2) moving to web-based programming: skills, training, support; (3) recruiting youth; and (4) challenges for implementation in a household environment; and (5) recommendations to overcome implementation challenges. These themes are complementary, connected, and should be considered holistically for the development, dissemination, and implementation of online sexual health programs for AI/AN youth, specifically during the COVID-19 pandemic. The results raised the following points for discussion: (1) Building partnerships with schools and community organizations facilitates program adaptation and implementation, (2) there is a need to adopt a holistic approach when addressing youth sexual health in AI/AN communities, (3) a systematic and culturally responsive adaptation approach ensures effective virtual program delivery, and (4) community and youth engagement is essential for the success of virtual sexual health programs. Conclusions Findings can provide recommendations on actions to be taken by sexual health educators and guidelines to follow to ensure cultural sensitivity, effective adaptation, and successful implementation when setting out to advocate for online sexual health programs for AI/AN youth.
Collapse
Affiliation(s)
- Lea Sacca
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Christine Markham
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Belinda Hernandez
- Center for Health Promotion and Prevention Research, University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Ross Shegog
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Melissa Peskin
- Center for Health Promotion and Disease Prevention, University of Texas Health Science Center Houston, Houston, TX, United States
| | | | - Hannah Warren
- Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Monique Tsosie
- Inter Tribal Council of Arizona, Phoenix, AZ, United States
| |
Collapse
|
6
|
Sacca L, Shegog R, Hernandez B, Peskin M, Rushing SC, Jessen C, Lane T, Markham C. Barriers, frameworks, and mitigating strategies influencing the dissemination and implementation of health promotion interventions in indigenous communities: a scoping review. Implement Sci 2022; 17:18. [PMID: 35189904 PMCID: PMC8862215 DOI: 10.1186/s13012-022-01190-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 01/18/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Many Indigenous communities across the USA and Canada experience a disproportionate burden of health disparities. Effective programs and interventions are essential to build protective skills for different age groups to improve health outcomes. Understanding the relevant barriers and facilitators to the successful dissemination, implementation, and retention of evidence-based interventions and/or evidence-informed programs in Indigenous communities can help guide their dissemination. PURPOSE To identify common barriers to dissemination and implementation (D&I) and effective mitigating frameworks and strategies used to successfully disseminate and implement evidence-based interventions and/or evidence-informed programs in American Indian/Alaska Native (AI/AN), Native Hawaiian/Pacific Islander (NH/PI), and Canadian Indigenous communities. METHODS A scoping review, informed by the York methodology, comprised five steps: (1) identification of the research questions; (2) searching for relevant studies; (3) selection of studies relevant to the research questions; (4) data charting; and (5) collation, summarization, and reporting of results. The established D&I SISTER strategy taxonomy provided criteria for categorizing reported strategies. RESULTS Candidate studies that met inclusion/exclusion criteria were extracted from PubMed (n = 19), Embase (n = 18), and Scopus (n = 1). Seventeen studies were excluded following full review resulting in 21 included studies. The most frequently cited category of barriers was "Social Determinants of Health in Communities." Forty-three percent of barriers were categorized in this community/society-policy level of the SEM and most studies (n = 12, 57%) cited this category. Sixteen studies (76%) used a D&I framework or model (mainly CBPR) to disseminate and implement health promotion evidence-based programs in Indigenous communities. Most highly ranked strategies (80%) corresponded with those previously identified as "important" and "feasible" for D&I The most commonly reported SISTER strategy was "Build partnerships (i.e., coalitions) to support implementation" (86%). CONCLUSION D&I frameworks and strategies are increasingly cited as informing the adoption, implementation, and sustainability of evidence-based programs within Indigenous communities. This study contributes towards identifying barriers and effective D&I frameworks and strategies critical to improving reach and sustainability of evidence-based programs in Indigenous communities. REGISTRATION NUMBER N/A (scoping review).
Collapse
Affiliation(s)
- Lea Sacca
- grid.267308.80000 0000 9206 2401Center for Health Promotion and Disease Prevention, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin, Houston, TX 77030 USA
| | - Ross Shegog
- grid.267308.80000 0000 9206 2401Center for Health Promotion and Disease Prevention, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin, Houston, TX 77030 USA
| | - Belinda Hernandez
- grid.267309.90000 0001 0629 5880Center for Health Promotion and Disease Prevention, University of Texas Health Science Center School of Public Health in San Antonio, 7411 John Smith Drive, Suite 1100, San Antonio, TX 78229 USA
| | - Melissa Peskin
- grid.267308.80000 0000 9206 2401Center for Health Promotion and Disease Prevention, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin, Houston, TX 77030 USA
| | - Stephanie Craig Rushing
- grid.422837.80000 0000 9966 8676Northwest Portland Area Indian Health Board, 2121 SW Broadway Suite 300, Portland, OR 97201 USA
| | - Cornelia Jessen
- grid.413552.40000 0000 9894 0703Alaska Native Tribal Health Consortium, 4000 Ambassador Drive, Anchorage, AK 99508 USA
| | - Travis Lane
- grid.470274.20000 0001 0023 3814Inter Tribal Council of Arizona, Inc., 2214 North Central Avenue, Phoenix, AZ 85004 USA
| | - Christine Markham
- grid.267308.80000 0000 9206 2401Center for Health Promotion and Disease Prevention, University of Texas Health Science Center at Houston School of Public Health, 7000 Fannin, Houston, TX 77030 USA
| |
Collapse
|
7
|
Olmsted AE, Markham CM, Shegog R, Ugueto AM, Johnson EL, Peskin MF, Emery ST, Baker KA, Newlin EW. Feasibility and Acceptability of Technology-supported Sexual Health Education Among Adolescents Receiving Inpatient Psychiatric Care. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:2050-2064. [PMID: 35221643 PMCID: PMC8857392 DOI: 10.1007/s10826-022-02259-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
Mental illness in adolescence is associated with high-risk sexual behaviors including multiple sex partners, infrequent or inconsistent condom use, and nonuse of contraception. Inpatient psychiatric care represents a promising setting to provide sexual health education. This pilot study investigates the feasibility and acceptability of online sexual health education in this group by assessing usability and impact on short-term psychosocial outcomes. We administered online modules on healthy relationships, pregnancy prevention, condom use, and sexually transmitted infection (STI) prevention to youth. We evaluated outcomes using a single group, pre/post-intervention design. One quality improvement session assessed staff acceptability of the programming. Participants included 51 inpatients (mean age = 15.3; 61% female; 57% Hispanic or Latino; 55% heterosexual). Overall, the program was feasible to administer and highly acceptable to youth (84-89% liked the modules, 98-100% found them easy to use, 96-100% found them credible, 91-98% said information would lead to healthier dating relationships, and 78-87% would refer to a friend). Youth who completed modules demonstrated improvement in several outcomes: attitudes and norms towards violence (p < 0.001), intention to use a method of birth control other than condoms if having sex in the next 3 months (p < 0.001), condom knowledge (p < 0.001), condom use self-efficacy (p < 0.001), condom beliefs (p = 0.04), HIV/STI knowledge (p < 0.001), and perceived susceptibility to STI (p < 0.01). The quality improvement session revealed high acceptability by nursing staff on the unit. This intervention could be useful and efficacious in an inpatient setting and larger studies are warranted to understand its full impact.
Collapse
Affiliation(s)
- Allison E. Olmsted
- The University of Texas Health Science Center, 7000 Fannin Street, Houston, TX 77030 USA
| | - Christine M. Markham
- The University of Texas Health Science Center, 7000 Fannin Street, Houston, TX 77030 USA
| | - Ross Shegog
- The University of Texas Health Science Center, 7000 Fannin Street, Houston, TX 77030 USA
| | | | | | - Melissa F. Peskin
- The University of Texas Health Science Center, 7000 Fannin Street, Houston, TX 77030 USA
| | - Susan T. Emery
- The University of Texas Health Science Center, 7000 Fannin Street, Houston, TX 77030 USA
| | - Kimberley A. Baker
- The University of Texas Health Science Center, 7000 Fannin Street, Houston, TX 77030 USA
| | | |
Collapse
|
8
|
Calac AJ, Bardier C, Cai M, Mackey TK. Examining Facebook Community Reaction to a COVID-19 Vaccine Trial on the Navajo Nation. Am J Public Health 2021; 111:1428-1430. [PMID: 34464193 DOI: 10.2105/ajph.2021.306202] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Alec J Calac
- All authors are with the University of California, San Diego, La Jolla. Alec Calac is also with the Joint Doctoral Program in Global Public Health, University of California, San Diego School of Medicine. Cortni Bardier, Mingxiang Cai, and Tim K. Mackey are also with the Global Health Policy and Data Institute, San Diego, CA
| | - Cortni Bardier
- All authors are with the University of California, San Diego, La Jolla. Alec Calac is also with the Joint Doctoral Program in Global Public Health, University of California, San Diego School of Medicine. Cortni Bardier, Mingxiang Cai, and Tim K. Mackey are also with the Global Health Policy and Data Institute, San Diego, CA
| | - Mingxiang Cai
- All authors are with the University of California, San Diego, La Jolla. Alec Calac is also with the Joint Doctoral Program in Global Public Health, University of California, San Diego School of Medicine. Cortni Bardier, Mingxiang Cai, and Tim K. Mackey are also with the Global Health Policy and Data Institute, San Diego, CA
| | - Tim K Mackey
- All authors are with the University of California, San Diego, La Jolla. Alec Calac is also with the Joint Doctoral Program in Global Public Health, University of California, San Diego School of Medicine. Cortni Bardier, Mingxiang Cai, and Tim K. Mackey are also with the Global Health Policy and Data Institute, San Diego, CA
| |
Collapse
|
9
|
Kaufman CE, Keane EM, Shangreau C, Arthur-Asmah R, Morse B, Whitesell NR. Dissemination and uptake of HIV/STD preventive interventions in American Indian and Alaska Native communities: a case study. ETHNICITY & HEALTH 2021; 26:352-363. [PMID: 30146899 DOI: 10.1080/13557858.2018.1514456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/23/2018] [Indexed: 06/08/2023]
Abstract
Objectives: HIV and sexually transmitted diseases (STDs) are serious health conditions among American Indian and Alaska Native (AIAN) populations, especially youth. However, few sexual risk reduction evidence-based interventions (EBIs) have been implemented by AIAN-serving organizations. This project sought to identify and assess the parameters facilitating the uptake and use of EBIs in order to strengthen opportunities for sustainability and improved sexual health among AIANs.Design: Guided by Rogers' theory of diffusion of innovation, we conducted a survey with a national sample of stakeholders involved with sexual health and well-being of AIAN youth (N = 142). We collected surveys for nine months beginning September 2010 and analyzed data in 2014 and 2015. We assessed respondents' perceptions of factors that might facilitate or hinder the use of a sexual risk reduction EBI, called RESPECT, in their communities. We regressed the scale of likely program uptake (alpha = 0.88) on each of five measures of perception of diffusion and uptake: trialability (extent new program can be altered), relative advantage (more advantageous than current program), observability (impact of program), complexity (difficulty of implementation), and compatibility (consistent with community values and practices).Results: Trialability (p = .009), observability (p = .003), and compatibility (p = .005) were found to be significantly related to program uptake in the adjusted model. Standardized betas showed that compatibility ranked highest of the three, followed by trialability and observability.Conclusions: For AIAN-serving organizations and AIAN communities, demonstrating trialability, compatibility, and observability of a sexual risk reduction EBI in specific cultural settings may increase likelihood of implementation and sustainability.
Collapse
Affiliation(s)
- Carol E Kaufman
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health - Anschutz Medical Campus, Aurora, CO, USA
| | - Ellen M Keane
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health - Anschutz Medical Campus, Aurora, CO, USA
| | - Carly Shangreau
- Great Plains Tribal Epidemiology Center, Great Plains Tribal Chairmen's Health Board, Rapid City, SD, USA
| | - Ruth Arthur-Asmah
- Children's Hospital Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Bradley Morse
- The Butler Institute, University of Denver, Denver, CO, USA
| | - Nancy R Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health - Anschutz Medical Campus, Aurora, CO, USA
| |
Collapse
|
10
|
Craig Rushing S, Stephens D, Shegog R, Torres J, Gorman G, Jessen C, Gaston A, Williamson J, Tingey L, Lee C, Apostolou A, Kaufman C, Markham CM. Healthy Native Youth: Improving Access to Effective, Culturally-Relevant Sexual Health Curricula. Front Public Health 2018; 6:225. [PMID: 30175091 PMCID: PMC6107849 DOI: 10.3389/fpubh.2018.00225] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/25/2018] [Indexed: 11/13/2022] Open
Abstract
Tribal health educators across the United States have found it challenging to locate engaging, culturally-relevant sexual health curricula for American Indian and Alaska Native (AI/AN) youth. Healthy Native Youth is a new online resource that provides a "one-stop-shop" for tribal health advocates to access age-appropriate curricula. The site was designed by a team of advisers representing a diverse group of tribal communities, using a collaborative planning process. The website content and navigation was then refined through usability testing with the target audience. The portal allows users to filter and compare curricula on multiple dimensions, including: age, delivery setting, duration, cost, and evidence of effectiveness, to determine best-fit. It includes all materials needed for implementation free-of-charge, including: facilitator training tools, lesson plans, materials to support participant marketing and recruitment, information about each program's cultural relevance, evaluation methods and findings, and references to publications and reports. The website currently includes mCircle of Life, Native It's Your Game, Native STAND, Native VOICES, and Safe in the Village, among others. Since its launch in August 2016, the site has had over 31,000 page views in all 50 States. The Healthy Native Youth portal provides educators in rural communities a promising new tool to support the dissemination and implementation of evidence-based health curricula in geographically-disbursed AI/AN communities. Lessons learned during the design and dissemination of the Healthy Native Youth website may be of value to other Indigenous populations interested in our approach and our findings.
Collapse
Affiliation(s)
| | - David Stephens
- Northwest Portland Area Indian Health Board, Portland, OR, United States
| | - Ross Shegog
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jennifer Torres
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Gwenda Gorman
- Inter Tribal Council of Arizona, Inc., Phoenix, AZ, United States
| | - Cornelia Jessen
- Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Amanda Gaston
- Northwest Portland Area Indian Health Board, Portland, OR, United States
| | - Jennifer Williamson
- Division of Community Health Services, Alaska Native Tribal Health Consortium, Anchorage, AK, United States
| | - Lauren Tingey
- Johns Hopkins Center for American Indian Health, Baltimore, MD, United States
| | - Crystal Lee
- UCLA David Geffen School of Medicine, Semel Institute for Neuroscience and Human Behavior, Global Center for Children and Families, Los Angeles, CA, United States
| | - Andria Apostolou
- Division of Epidemiology and Disease Prevention, Indian Health Service, Rockville, MD, United States
| | - Carol Kaufman
- Colorado School of Public Health, Centers for American Indian and Alaska Native Health, Aurora, CO, United States
| | - Christine Margaret Markham
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, United States
| |
Collapse
|
11
|
Lys C, Gesink D, Strike C, Larkin J. Body Mapping as a Youth Sexual Health Intervention and Data Collection Tool. QUALITATIVE HEALTH RESEARCH 2018; 28:1185-1198. [PMID: 29303048 PMCID: PMC5960841 DOI: 10.1177/1049732317750862] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In this article, we describe and evaluate body mapping as (a) an arts-based activity within Fostering Open eXpression Among Youth (FOXY), an educational intervention targeting Northwest Territories (NWT) youth, and (b) a research data collection tool. Data included individual interviews with 41 female participants (aged 13-17 years) who attended FOXY body mapping workshops in six communities in 2013, field notes taken by the researcher during the workshops and interviews, and written reflections from seven FOXY facilitators on the body mapping process (from 2013 to 2016). Thematic analysis explored the utility of body mapping using a developmental evaluation methodology. The results show body mapping is an intervention tool that supports and encourages participant self-reflection, introspection, personal connectedness, and processing difficult emotions. Body mapping is also a data collection catalyst that enables trust and youth voice in research, reduces verbal communication barriers, and facilitates the collection of rich data regarding personal experiences.
Collapse
Affiliation(s)
- Candice Lys
- University of Toronto, Toronto, Ontario, Canada
- Fostering Open eXpression Among Youth, Yellowknife, Northwest Territories, Canada
| | | | - Carol Strike
- University of Toronto, Toronto, Ontario, Canada
- St. Michael’s Hospital, Toronto, Ontario, Canada
| | - June Larkin
- University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|