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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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Kaufman CE, Asdigian NL, Reed ND, Shrestha U, Bull S, Begay RL, Shangreau C, Howley CT, Vossberg RL, Sarche M. A virtual randomized controlled trial of an alcohol-exposed pregnancy prevention mobile app with urban American Indian and Alaska Native young women: Native WYSE CHOICES rationale, design, and methods. Contemp Clin Trials 2023; 128:107167. [PMID: 37001855 PMCID: PMC10290431 DOI: 10.1016/j.cct.2023.107167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/13/2023] [Accepted: 03/22/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Fetal Alcohol Spectrum Disorders (FASD) result in lifelong disability and are a leading cause of preventable birth defects in the US, including for American Indian and Alaska Natives (AIANs). Prevention of alcohol exposed pregnancies (AEPs), which can cause FASD, is typically aimed at adult women who are risky drinkers and have unprotected sex. Among AIANs, AEP prevention research has been primarily conducted in reservation communities, even though over 70% of AIANs live in urban areas. Culturally appropriate AEP prevention for urban AIAN young women, regardless of current drinking or sexual behaviors, may maximize the potential for primary prevention at the beginning of the reproductive years for this underserved population. METHODS We developed a virtual randomized controlled trial (RCT) - fully implemented through technology - to evaluate Native WYSE CHOICES, a culturally tailored mobile app, with urban AIAN young women ages 16-20 nationally. While virtual RCTs are not new, this is the first engaging a solely urban AIAN population, historically excluded from research. Participants are recruited on a rolling basis through the project social media community, organizational partnerships, and in-person events. Eligible participants complete a baseline survey and are randomized to either the app's intervention or comparison arm - each of which provide about 3 h of content. Follow-up data are collected at 1-, 6-, and 12-months post-baseline. RESULTS Our study offers a template for building trust and extending reach to this underserved population while also providing important lessons and insights on advances in virtual or hybrid research approaches.
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Affiliation(s)
- Carol E Kaufman
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Nancy L Asdigian
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Nicole D Reed
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Umit Shrestha
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Sheana Bull
- mHealth Impact Lab, Department of Community and Behavioral Health, Colorado School of Public Health, Mail Stop F802, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Rene L Begay
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Carly Shangreau
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Caitlin Trucksess Howley
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Raeann L Vossberg
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
| | - Michelle Sarche
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Mail Stop F800, 13055 East 17(th) Avenue, Aurora, CO 80045, United States of America.
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Stephens D, Peterson R, Singer M, Johnson J, Rushing SC, Kelley A. Recruiting and Engaging American Indian and Alaska Native Teens and Young Adults in a SMS Help-Seeking Intervention: Lessons Learned from the BRAVE Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9437. [PMID: 33339260 PMCID: PMC7765783 DOI: 10.3390/ijerph17249437] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/10/2020] [Accepted: 12/14/2020] [Indexed: 12/26/2022]
Abstract
This paper shares lessons learned recruiting and engaging participants in the BRAVE study, a randomized controlled trial carried out by the Northwest Portland Area Indian Health Board and the mHealth Impact Lab. The team recruited 2330 American Indian/Alaska Native (AI/AN) teens and young adults nationwide (15-24 years old) via social media channels and text message and enrolled 1030 to participate in the 9 month study. Teens and young adults who enrolled in this study received either: 8 weeks of BRAVE text messages designed to improve mental health, help-seeking skills, and promote cultural pride and resilience; or 8 weeks of Science Technology Engineering and Math (STEM) text messages, designed to elevate and re-affirm Native voices in science, technology, engineering, math and medicine; and then received the other set of messages. Results indicate that social media channels like Facebook and Instagram can be used to recruit AI/AN teens and young adults. Retention in this study was high, with 87% of participants completing both the BRAVE and STEM intervention arms. Lessons learned from this process may help teen and young adult-serving organizations, prevention programs, policy makers, researchers, and educators as they support the next generation of AI/AN change makers.
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Affiliation(s)
- David Stephens
- Northwest Portland Area Indian Health Board, 2121 SW Broadway #300, Portland, OR 97201, USA; (D.S.); (R.P.); (M.S.); (J.J.)
| | - Roger Peterson
- Northwest Portland Area Indian Health Board, 2121 SW Broadway #300, Portland, OR 97201, USA; (D.S.); (R.P.); (M.S.); (J.J.)
| | - Michelle Singer
- Northwest Portland Area Indian Health Board, 2121 SW Broadway #300, Portland, OR 97201, USA; (D.S.); (R.P.); (M.S.); (J.J.)
| | - Jacqueline Johnson
- Northwest Portland Area Indian Health Board, 2121 SW Broadway #300, Portland, OR 97201, USA; (D.S.); (R.P.); (M.S.); (J.J.)
| | - Stephanie Craig Rushing
- Northwest Portland Area Indian Health Board, 2121 SW Broadway #300, Portland, OR 97201, USA; (D.S.); (R.P.); (M.S.); (J.J.)
| | - Allyson Kelley
- Allyson Kelley & Associates, Principal, 69705 Lake Drive, Sisters, OR 97759, USA;
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Abstract
PURPOSE OF REVIEW To highlight research, publications, and medical advancements in fetal alcohol spectrum disorder (FASD) over the past 18 months. RECENT FINDINGS Prevalence numbers have been updated, allowing for a more accurate account of the societal impact. Further work on diagnostic techniques and the underlying mechanisms will allow us to better understand the pathophysiology of FASD and could translate into treatments for the condition. Continued research on new treatments and interventions is needed to improve the affected individual's health care and quality of life. Measurable outcomes allow us to tangibly measure improvements for individuals and families affected by FASD. SUMMARY The current review highlights recent publications from January 2018 to August 2019 showing continued medical advancement in improving the care for children and families affected by FASD.
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Affiliation(s)
- Joshua J Baker
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts, USA
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Burd L, Popova S. Fetal Alcohol Spectrum Disorders: Fixing Our Aim to Aim for the Fix. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3978. [PMID: 31635265 PMCID: PMC6843765 DOI: 10.3390/ijerph16203978] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 10/12/2019] [Indexed: 11/20/2022]
Abstract
We, as editors of this special issue on Fetal Alcohol Spectrum Disorders (FASD), are proud to present eleven papers [...].
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Affiliation(s)
- Larry Burd
- North Dakota Fetal Alcohol Syndrome Center, Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Pediatric Therapy Services, Altru Health System, Grand Forks, ND 58202, USA.
| | - Svetlana Popova
- Institute for Mental Health Policy Research & Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, (CAMH), Toronto, ON M6J 1H4, Canada.
- Epidemiology Division, Office of Global Public Health Education & Training, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5S 1A1, Canada.
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON M5S 1A1, Canada.
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