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Kulis SS, Tsethlikai M, Ayers SL, Gresenz KE. Parenting in 2 Worlds: Testing improved parent-adolescent communication about sexuality in Urban American Indian families. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2024; 34:56-68. [PMID: 37957746 PMCID: PMC10926230 DOI: 10.1111/jora.12900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 11/15/2023]
Abstract
Urban American Indian (AI) adolescents are more likely than non-Natives to have early sexual debut, teen pregnancies, sexually transmitted infections, and inadequate sexual health information. A RCT in three Arizona cities, with 585 parents of urban AI adolescents, tested whether a culturally tailored parenting intervention for urban AI families, Parenting in 2 Worlds (P2W), increased parent-adolescent communication about sexuality, compared to an informational family health intervention that was not culturally tailored. P2W produced significantly larger increases on two measures: communication about general sexual health and about sexual decision-making. The desired effects of P2W on the first measure were stronger short-term for cross-gender dyads, while for the second measure, they were stronger long-term for both mothers and fathers of adolescent sons.
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Affiliation(s)
- Stephen S. Kulis
- School of Social and Family Dynamics, Arizona State
University
- Global Center for Applied Health Research, Arizona State
University
| | | | | | - Kyle E. Gresenz
- School of Social and Family Dynamics, Arizona State
University
- Global Center for Applied Health Research, Arizona State
University
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2
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Tuitt NR, Wexler LM, Kaufman CE, Whitesell NR, Rink E, Anastario M, Ivanich JD, Belone L, Moore RS, Huh D, Campbell TE, Allen J. Unsettling Settler Colonialism in Research: Strategies Centering Native American Experience and Expertise in Responding to Substance Misuse and Co-occurring Sexual Risk-Taking, Alcohol-Exposed Pregnancy, and Suicide Prevention Among Young People. ADVERSITY AND RESILIENCE SCIENCE 2023; 4:389-400. [PMID: 38045956 PMCID: PMC10688593 DOI: 10.1007/s42844-023-00100-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 12/05/2023]
Abstract
Native American (NA) populations in the USA (i.e., those native to the USA which include Alaska Natives, American Indians, and Native Hawaiians) have confronted unique historical, sociopolitical, and environmental stressors born of settler colonialism. Contexts with persistent social and economic disadvantage are critical determinants of substance misuse and co-occurring sexual risk-taking and suicide outcomes, as well as alcohol exposed pregnancy among NA young people (i.e., adolescents and young adults). Despite intergenerational transmission of resistance and resiliencies, NA young people face continued disparities in substance misuse and co-occurring outcomes when compared to other racial and ethnic groups in the USA. The failure in progress to address these inequities is the result of a complex set of factors; many of which are structural and rooted in settler colonialism. One of these structural factors includes barriers evident in health equity research intended to guide solutions to address these disparities yet involving maintenance of a research status quo that has proven ineffective to developing these solutions. Explicitly or implicitly biased values, perspectives, and practices are deeply rooted in current research design, methodology, analysis, and dissemination and implementation efforts. This status quo has been supported, intentionally and unintentionally, by researchers and research institutions with limited experience or knowledge in the historical, social, and cultural contexts of NA communities. We present a conceptual framework illustrating the impact of settler colonialism on current research methods and opportunities to unsettle its influence. Moreover, our framework illustrates opportunities to resist settler colonialism in research. We then focus on case examples of studies from the Intervention Research to Improve Native American Health program, funded by the NIH, that impact substance use and co-occurring health conditions among NA young people.
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Affiliation(s)
- Nicole R. Tuitt
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lisa M. Wexler
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Carol E. Kaufman
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Nancy Rumbaugh Whitesell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Elizabeth Rink
- Center for American Indian and Rural Health Equity, College of Education, Health, and Human Resources, Montana State University, Bozeman, MT, USA
| | - Michael Anastario
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Jerreed D. Ivanich
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lorenda Belone
- Center for Participatory Research, Department of Health, Exercise, and Sports Science, University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Roland S. Moore
- Pacific Institute for Research and Evaluation, Albuquerque, NM, USA
| | - David Huh
- School of Social Work, University of Washington, Seattle, WA, USA
| | | | - James Allen
- Department of Family Medicine and Biobehavioral Health, University of Minnesota, Minneapolis, MN, USA
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Tidmarsh G, Whiting R, Thompson JL, Cumming J. Assessing the fidelity of delivery style of a mental skills training programme for young people experiencing homelessness. EVALUATION AND PROGRAM PLANNING 2022; 94:102150. [PMID: 35952482 DOI: 10.1016/j.evalprogplan.2022.102150] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/10/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
There is a need for positive youth development/strengths-based approaches to support the wellbeing and social inclusion of young people experiencing or at risk of homelessness. My Strengths Training for Life™ (MST4Life™) uses a strengths-based approach with the aim to improve young people's resilience, self-worth, wellbeing and engagement in education, employment, and training. This mixed methods study assessed the fidelity of delivery style of the MST4Life™ programme, the extent to which frontline service staff can delivery psychologically informed programmes to service users and identified barriers and enablers to delivering with fidelity to the intended style. Observations of programme delivery (two facilitators per session) took place across early, middle, and late phases of the programme across a pilot phase (n = 18) and main study (n = 45). Facilitators also completed self-reflection forms following each session. The mean observation score was 82.2 ± 15.7 %, and facilitator self-report mean adherence score was 89.3 ± 6.2 % which indicate that the programme was delivered with high fidelity. Quantitative data was also analysed using non-parametric statistical test (Mann-Whitney U Test). There was a significant difference between observation scores for deliverers with postgraduate psychology training compared to deliverers without postgraduate psychology training (p = .029). Qualitative data were analysed using inductive thematic analysis. Barriers and enablers included communication, frontline staff support, logistics, and participant behaviours. Overall, this study highlights that despite the challenges of delivering complex community programmes to young people experiencing homelessness, it was possible for frontline service staff to deliver MST4Life™ with high fidelity.
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Affiliation(s)
- Grace Tidmarsh
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom.
| | - Richard Whiting
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom
| | - Janice L Thompson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom
| | - Jennifer Cumming
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, United Kingdom; Institute for Mental health, University of Birmingham, United Kingdom
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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.
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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
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Peterson M, Rink E, Schure M, Mikkelsen K, Longtree H, FireMoon P, Johnson O. Early childbearing, family support, and staying in school in a Northern Plains American Indian reservation. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2022; 17:510-535. [PMID: 37427389 PMCID: PMC10328454 DOI: 10.1080/15546128.2022.2053258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
American Indian youth experience teen birth and school dropout at higher rates than other racial and ethnic groups in the United States. Early childbearing is associated with adverse health and socioeconomic outcomes, including attenuated education. However, kinship childrearing norms among Northern Plains tribes can support positive experiences of early childbearing. Using a community based participatory research framework, this mixed methods exploratory study engaged high school students from a Northern Plains reservation community to examine youth perceptions of family support and belief in ability to stay in school should they have a child. We elicited youth observations of facilitators and inhibitors to academic achievement for young parents. This research supports the need for strengths-based, gender specific, and family inclusive sexuality education to support young people in their reproductive choices in reservation settings. We highlight the utility of including youth as co-authors and co-researchers in future studies.
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Affiliation(s)
- Malory Peterson
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Mark Schure
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
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Banyard V, Edwards K, Herrington R, Hopfauf S, Simon B, Shroll L. Using photovoice to understand and amplify youth voices to prevent sexual and relationship violence. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:90-110. [PMID: 33331652 DOI: 10.1002/jcop.22495] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
AIMS Efforts to improve prevention of sexual and relationship violence (SRV) among adolescents call for more centering of youth voices, experiences, and skills to design prevention programs that incorporate youth engagement rather than those that are designed by adults for youth. Amplifying the voices of historically marginalized youth are especially needed. Photovoice (PV) is a participatory action method that can empower youth and generate prevention knowledge. METHODS The current project used PV to engage youth in late middle and early high school to discuss how they could work to prevent SRV in their community. A convenience sample of nine youth (predominately Native American) participated over seven sessions. RESULTS A key theme they generated is that SRV prevention needs to be viewed as relational. Participants described the complexity of prevention, including how youth need social support to thrive and prevent SRV and that asking for help can be challenging. Results also highlighted that youth can provide help and support, but it is not always welcome in addition to underscoring that youth are resilient and can be prevention leaders. CONCLUSION Innovations in SRV prevention, especially for older adolescents, should work to engage youth as prevention partners. Participatory research methods like photovoice can be an important part of that process.
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Affiliation(s)
- Victoria Banyard
- School of Social Work, Center on Violence Against Women and Children, Rutgers University, New Brunswick, New Jersey, USA
| | - Katie Edwards
- Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Ramona Herrington
- Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Skyler Hopfauf
- Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Briana Simon
- Center for Research on Children, Youth, Families, and Schools, University of Nebraska Lincoln, Lincoln, Nebraska, USA
| | - Linda Shroll
- Working Against Violence, Inc, Rapid City, South Dakota, USA
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Hanson JD, Weber TL, Shrestha U, Bares VJ, Seiber M, Ingersoll K. Acceptability of an eHealth Intervention to Prevent Alcohol-Exposed Pregnancy Among American Indian/Alaska Native Teens. Alcohol Clin Exp Res 2020; 44:196-202. [PMID: 31693195 PMCID: PMC6980937 DOI: 10.1111/acer.14229] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/26/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND A tribally led Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (CHOICES) Program has successfully decreased the risk of alcohol-exposed pregnancies (AEPs) among adult American Indian/Alaska Native (AI/AN) women by either reducing risky drinking or increasing contraception use. However, a community needs assessment revealed a need to implement a similar intervention with AI/AN teens. The goal of the project was to develop and establish the acceptability of CHOICES for AI/AN teens. METHODS Key informant interviews were conducted to review the existing OST CHOICES intervention. After modifications to the existing program, focus groups with AI/AN teens were conducted to ensure validity and to finalize the OST CHAT (CHOICES for American Indian Teens) intervention. RESULTS Key informant (N = 15) participants suggested that a Web-based intervention may increase teen engagement by making the intervention more interactive and visually stimulating. Based on this formative research, CHAT was developed via Research Electronic Data Capture (REDCap). Feedback on the online CHAT curriculum was given by focus groups comprised of AI/AN adolescents, and participants felt that this type of intervention would be both acceptable and able to implement with a community of reservation-based teens. CONCLUSIONS This study outlines the development of a Web-based intervention for an AEP intervention for AI/AN teens and will inform future prevention efforts. Implications include an expansion of the evidence-based CHOICES intervention for AI/AN teens and also development of a Web-based intervention for rural, reservation-based AI/AN communities.
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Affiliation(s)
| | | | | | | | | | - Karen Ingersoll
- University of Virginia School of Medicine, Charlottesville, VA USA
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Shrestha U, Hanson J, Weber T, Ingersoll K. Community Perceptions of Alcohol Exposed Pregnancy Prevention Program for American Indian and Alaska Native Teens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1795. [PMID: 31117177 PMCID: PMC6572356 DOI: 10.3390/ijerph16101795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 05/16/2019] [Accepted: 05/18/2019] [Indexed: 12/14/2022]
Abstract
A community needs assessment during a tribally-led Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (CHOICES) intervention highlighted the need to reduce the risk for alcohol exposed pregnancy (AEP) among American Indian and Alaska Native (AIAN) adolescent girls. The CHOICES for American Indian Teens (CHAT) Program aims to reduce the risk of AEP among AIAN teens in one Northern Plains tribal community. The CHAT team adopted an iterative process to modify the tribally-led CHOICES curriculum for AIAN teens. This paper describes the iterative process as well as the community perception towards AEP prevention among AIAN teens. The CHAT team conducted several levels of formative and qualitative research, including one-on-one interviews (n = 15) with community members, AIAN elders and school counsellors; and three focus groups with AIAN adolescent girls (n = 15). A qualitative data analysis identified several recommendations that centered on making the information regarding alcohol and birth control appealing to teens; ensuring the confidentiality of the participants; making the program culturally relevant; and including boys in the program. This study outlines various components prioritized by community members in creating a culturally-relevant and age-appropriate AEP prevention program and provides community perceptions of AEP prevention for the teens in this community.
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Affiliation(s)
- Umit Shrestha
- Department of Community and Behavioral Health, Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13055 East 17th Avenue, Aurora, CO 80045, USA.
| | - Jessica Hanson
- Behavioral Sciences, Sanford Research, 2301 East 60th Street North, Sioux Falls, SD 57104, USA.
| | - Tess Weber
- Behavioral Sciences, Sanford Research, 2301 East 60th Street North, Sioux Falls, SD 57104, USA.
| | - Karen Ingersoll
- University of Virginia School of Medicine, 310 Old Ivy Way, Charlottesville, VA 22903, USA.
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