Search

The goal of this paper is to discuss practical recommendations for collecting data with hard to reach populations and data comparability. We also discuss the importance of piloting and community involvement in the process using an example from the Tribal Prevention Initiative (TiPI), a culturally-based substance abuse prevention program for American Indian youth from six tribes in Montana and Wyoming. We piloted a survey based on standardized Youth Risk Factor Behavioral Surveillance Survey questions (YRBSS) in tribal communities to document substance use and norms. The revised TiPI survey resulted in a 16-question survey (N=711). We compared TiPI data with the YRBSS data from 2015 to 2019. Descriptive statistics (frequency (n) and percent (%) or mean (M) and standard deviation (SD)) were used to analyze data. Results indicate that substance use is generally lower among TiPI youth than YRBS youth in reservation and urban locations with the exception of middle school marijuana use and urban binge drinking. To improve public health and document progress toward healthy future generations, communities must be aware of the unique challenges of using national surveys like the YRBSS as comparison data, and the strengths of primary data collection driven by program needs.

Objectives To explore health behavior profiles of AI/AN youth involved in native students together against negative decisions (STAND), a national culture-based curriculum. Methods We analyzed data from 1236 surveys conducted among AI/AN youth at 40 native STAND implementation sites located in 16 states throughout the US from 2014 to 2017. Health profiles included demographics, sexual orientation, sexual activity, STI testing, cigarette use, and suicide attempts in the past 12-months. We used t-tests and chi square tests of independence to compare risk behavior prevalence among the sample. Results Health behavior profiles of AI/AN youth indicate that 45.6% of youth did not use condoms the last time they had sex, and 82.7% have never been tested for STIs. Differences in cigarette smoking were observed in questioning youth (questioning: 80.3%, straight/heterosexual: 63.8%, LGBTQ2S + : 49.9%, p = 0.03). Conclusions for Practice Health behaviors related to sex, substance, violence and self-harm, are at least as common for AI/AN youth as those observed in other US teens. Future research should consider similarities and differences in health profiles of AI/AN youth when designing interventions that affect them. Further, our findings underscore the need for culturally-relevant curricula like native STAND, not because their health behavior is different, but because their socio-ecologic environment is different., Author(s): Megan Skye [sup.1] , Stephanie Craig [sup.2] , Caitlin Donald [sup.1] , Allyson Kelley [sup.3] , Brittany Morgan [sup.1] , Kavita Rajani [sup.1] , Michelle Singer [sup.2] , Tosha [...]

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. [ABSTRACT FROM AUTHOR]

Objectives: This qualitative evaluation was guided by two questions: 1) How does peer recovery support (PRS) support American Indian (AI) people in recovery from substance use disorders? and 2) What makes PRS effective? Methods: We utilized a descriptive qualitative study design to explore the essence of PRS. Semi-structured interviews were conducted with six AI peers to explore the perceptions and lived experiences of recovery from one urban Montana location. Data analysis involved coding all the transcripts using the priori codes developed, then identifying key themes from the coded data. Results: Themes and interview data helped us explore how PRS supports recovery and potential reasons why it is effective for AI populations. Peers indicated that the program helped them maintain their recovery, and the role of peer mentors was critical to their success. Themes of belonging, connection, and compassion were common among peers interviewed. They also felt that recovery is a spiritual process. The peers had limited recommendations for improving the program, except the need for funding sustainability. Conclusions: Understanding how people recover is the first step in addressing the current substance misuse epidemic facing our nation. This evaluation outlined the qualitative impacts of PRS, the spiritual nature of PRS, the context of PRS, and recommendations from peers involved in the program. More work is needed to explore how to sustain PRS programs and integrate PRS into existing community-based settings, like churches, social services, urban AI centers, and other locations. [ABSTRACT FROM AUTHOR]

Introduction: Structural racism, bias, and discrimination within institutions of higher education prevent Hispanic women from becoming university leaders and professors, especially when they do not have a formal degree. Hispanic leaders in higher education often have lived experiences based on their cultural values, family connections, and time working in community settings. However, lived experience is not always viewed as an equal qualification to college degrees when it comes to teaching, leading, or managing programs and departments. Methods: The purpose of this study is to present a case study of one program operations director (leader) working at a University who does not have a terminal or advanced degree but holds the lived and professional experiences of working in community health worker programs with minority and underserved populations. This study examined her experience as a Hispanic female leading in higher education. We used qualitative phenomenological methods grounded in a descriptive case study design to inform our work. Results: The themes from the analysis process represent how LE influences the participant's work as a leader in academia and give insight into how she navigates academia without a college degree. Discussion: Higher education must meet the needs of Hispanic students and leaders. By elevating Hispanic women in leadership positions, even without degrees, institutions of higher education are demonstrating a commitment to Hispanic student support, development, diversity, and culture. [ABSTRACT FROM AUTHOR]

American Indian (AI) and Alaska Native (AN) community stakeholder engagement has the power to transform health research. However, the engagement and dissemination process is challenging in AIAN communities due to the historical and current negative experiences of AIAN populations in health research (Dillard et al., 2018). Whereas there is a paucity of recommendations about how to engage stakeholders in health research, from agenda-setting to proposal development, study design, recruitment, data collection, analysis, results, and dissemination (Concannon et al., 2014), there is limited information about how these recommendations are operationalized within the context of AIAN health research and practice (Concannon et al., 2014; Forsythe et al., 2016). For the purposes of this article, stakeholders are individuals, organizations, or communities who have a direct interest in the process and outcomes of a project, research, or policy effort (Boaz et al., 2018). Stakeholder engagement is a systematic process involving stakeholders, which provides opportunities for consultation, input, reviews, reactions, support, and assistance with dissemination. Dissemination focuses on how, when, by whom, and under what circumstances evidence spreads throughout agencies, organizations, states, counties, communities, tribes, researchers, policy makers, and service organizations. [ABSTRACT FROM AUTHOR]

Copyright of World Medical & Health Policy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)