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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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Charron-Prochownik D, Moore KR, Stotz S, Akers A, Beirne S, Brega AG, Chalmers L, Fischl A, Garrow H, Gonzales K, Nadeau KJ, O'Banion N, Powell J, Seely E, Powell B, Abujaradeh H, Sereika SM. Comparing American Indian/Alaska Native Adolescent Daughters' and Their Mothers' Awareness, Knowledge, Attitudes, and Behaviors Regarding Risk for Gestational Diabetes: Implications for Mother-Daughter Communication on Reproductive Health. Sci Diabetes Self Manag Care 2023; 49:267-280. [PMID: 37332238 DOI: 10.1177/26350106231178837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
PURPOSE The purpose of the study was to describe, compare, and examine associations at baseline of reproductive health awareness, knowledge, health beliefs, communication and behaviors related to gestational diabetes (GDM) and GDM risk reduction in a vulnerable population of both American Indian/Alaska Native (AIAN) adolescent girls and their mothers. METHODS Descriptive/comparative/correlational analyses examined multitribal baseline data on 149 mother-daughter (M-D) dyads (N = 298; daughter age = 12-24 years) enrolled in a longitudinal study to adapt and evaluate a culturally relevant diabetes preconception counseling (PC) program (Stopping-GDM). The associations between GDM risk reduction awareness, knowledge, health beliefs, and behaviors (eg, daughters' eating, physical activity, reproductive-health [RH] choices/planning, M-D communication, daughters' discussions on PC) were examined. Data collected online from 5 national sites. RESULTS Many M-D lacked awareness/knowledge of GDM and risk reduction. Both M-D were unaware of the girl's risk for GDM. Mothers' knowledge and beliefs on GDM prevention/RH were significantly higher than daughters. Younger daughters had greater self-efficacy healthy living. Overall sample reported low to moderate scores for both M-D communication and daughters' GDM and RH risk-reduction behaviors. CONCLUSIONS Knowledge, communication, and behaviors to prevent GDM were low in AIAN M-D, especially daughters. More than daughters, mothers perceive greater risk of GDM for daughters. Early culturally responsive dyadic PC programs could help decrease risk of developing GDM. Implications for M-D communication is compelling.
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Affiliation(s)
| | - Kelly R Moore
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sarah Stotz
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Sandra Beirne
- Navajo Area Indian Health Service, Shiprock, New Mexico
| | - Angela G Brega
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Andrea Fischl
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | | | | | - Kristen J Nadeau
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Nancy O'Banion
- Indian Health Care Resource Center of Tulsa, Tulsa, Oklahoma
| | - Jeff Powell
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | - Ellen Seely
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Blair Powell
- Navajo Area Indian Health Service, Shiprock, New Mexico
| | - Hiba Abujaradeh
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | - Susan M Sereika
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
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Watson D, Mhlaba M, Molelekeng G, Chauke TA, Simao SC, Jenner S, Ware LJ, Barker M. How do we best engage young people in decision-making about their health? A scoping review of deliberative priority setting methods. Int J Equity Health 2023; 22:17. [PMID: 36698119 PMCID: PMC9876416 DOI: 10.1186/s12939-022-01794-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/18/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION International organisations have called to increase young people's involvement in healthcare and health policy development. We currently lack effective methods for facilitating meaningful engagement by young people in health-related decision-making. The purpose of this scoping review is to identify deliberative priority setting methods and explore the effectiveness of these in engaging young people in healthcare and health policy decision-making. METHODS Seven databases were searched systematically, using MeSH and free text terms, for articles published in English before July 2021 that described the use of deliberative priority setting methods for health decision-making with young people. All titles, abstracts and full-text papers were screened by a team of six independent reviewers between them. Data extraction followed the Centre for Reviews and Dissemination guidelines. The results are presented as a narrative synthesis, structured around four components for evaluating deliberative processes: 1) representation and inclusion of diverse participants, 2) the way the process is run including levels and timing of participant engagement, 3) the quality of the information provided to participants and 4) resulting outcomes and decisions. FINDINGS The search yielded 9 reviews and 21 studies. The more engaging deliberative priority setting tools involved young people-led committees, mixed methods for identifying and prioritising issues and digital data collection and communication tools. Long-term and frequent contact with young people to build trust underpinned the success of some of the tools, as did offering incentives for taking part and skills development using creative methods. The review also suggests that successful priority setting processes with young people involve consideration of power dynamics, since young people's decisions are likely to be made together with family members, health professionals and academics. DISCUSSION Young people's engagement in decision-making about their health is best achieved through investing time in building strong relationships and ensuring young people are appropriately rewarded for their time and contribution. If young people are to be instrumental in improving their health and architects of their own futures, decision-making processes need to respect young people's autonomy and agency. Our review suggests that methods of power-sharing with young people do exist but that they have yet to be adopted by organisations and global institutions setting global health policy.
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Affiliation(s)
- Daniella Watson
- Global Health Research Institute, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK. .,SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa. .,Department of Global Health and Social Medicine, King's College London, London, UK.
| | - Mimi Mhlaba
- grid.11951.3d0000 0004 1937 1135SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Gontse Molelekeng
- grid.11951.3d0000 0004 1937 1135SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Thulani Andrew Chauke
- grid.412801.e0000 0004 0610 3238Department of Adult, College of Education, Community and Continuing Education, University of South Africa, Pretoria, South Africa
| | - Sara Correia Simao
- grid.5491.90000 0004 1936 9297Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Sarah Jenner
- grid.5491.90000 0004 1936 9297Medical Research Council Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Lisa J. Ware
- grid.11951.3d0000 0004 1937 1135SAMRC Developmental Pathways for Health Research Unit, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa ,grid.11951.3d0000 0004 1937 1135DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Mary Barker
- grid.5491.90000 0004 1936 9297Global Health Research Institute, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK ,grid.5491.90000 0004 1936 9297School of Health Sciences, Faculty of Life and Environmental Sciences, University of Southampton, Southampton, UK ,grid.11951.3d0000 0004 1937 1135School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa ,grid.430506.40000 0004 0465 4079NIHR Southampton Biomedical Research Centre, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
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Rink E, Firemoon P, Anastario M, Johnson O, GrowingThunder R, Ricker A, Peterson M, Baldwin J. Rationale, Design, and Methods for Nen Unkumbi/Edahiyedo ("We Are Here Now"): A Multi-Level Randomized Controlled Trial to Improve Sexual and Reproductive Health Outcomes in a Northern Plains American Indian Reservation Community. Front Public Health 2022; 10:823228. [PMID: 35910931 PMCID: PMC9326233 DOI: 10.3389/fpubh.2022.823228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 04/29/2022] [Indexed: 12/01/2022] Open
Abstract
American Indian (AI) youth in the United States experience disproportionate sexual and reproductive health (SRH) disparities relative to their non-Indigenous, white counterparts, including increased rates of sexually transmitted infections (STIs), earlier sexual debut, increased rates of teen birth, and reduced access to SRH services. Past research shows that to improve SRH outcomes for AI youth in reservation communities, interventions must address complex factors and multiple levels of community that influence sexual risk behaviors. Here, we describe development of a multi-level, multi-component randomized controlled trial (RCT) to intervene upon SRH outcomes in a Northern Plains American Indian reservation community. Our intervention is rooted in a community based participatory research framework and is evaluated with a stepped wedge design that integrates 5 reservation high schools into a 5-year, cluster-randomized RCT. Ecological Systems Theory was used to design the intervention that includes (1) an individual level component of culturally specific SRH curriculum in school, (2) a parental component of education to improve parent-child communication about SRH and healthy relationships, (3) a community component of cultural mentorship, and (4) a systems-level component to improve delivery of SRH services from reservation healthcare agencies. In this article we present the rationale and details of our research design, instrumentation, data collection protocol, analytical methods, and community participation in the intervention. Our intervention builds upon existing community strengths and integrates traditional Indigenous knowledge and values with current public health knowledge to reduce SRH disparities.
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Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | | | - Michael Anastario
- AHC5, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, United States
| | | | - Ramey GrowingThunder
- Language and Culture Department, Fort Peck Assiniboine and Sioux Tribes, Poplar, MT, United States
| | - Adriann Ricker
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Malory Peterson
- Department of Health and Human Development, Montana State University, Bozeman, MT, United States
| | - Julie Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ, United States
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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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Participatory Action Research for Adolescent Sexual and Reproductive Health: A Scoping Review. SEXES 2022. [DOI: 10.3390/sexes3010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Youth-friendly sexual and reproductive health (SRH) interventions are essential for the health of adolescents (10–19 years). Co-designing is a participatory approach to research, allowing for collaboration with academic and non-academic stakeholders in intervention development. Participatory action research (PAR) involves stakeholders throughout the planning, action, observation, and reflection stages of research. Current knowledge indicates that co-producing SRH interventions with adolescents increases a feeling of ownership, setting the scene for intervention adoption in implementation settings. Objectives: This scoping review aims to understand the extent of adolescents’ participation in PAR steps for co-designed SRH interventions, including the barriers and facilitators in co-designing of SRH intervention, as well as its effectiveness on adolescents’ SRH outcomes. Methods: Database searching of PubMed, Medline, Embase, CINAHL, Scopus, Web of Science, Google Scholar, and organisational websites was performed, identifying 439 studies. Results: Upon screening, 30 studies (published between 2006–2021) met the inclusion criteria. The synthesis identified that adolescents were involved in the planning and action stages of the interventions, but not in the observation and reflection stages. Although the review identified the barriers and facilitators for co-designing SRF interventions, none of the included studies reported on the effectiveness of co-designing SRH interventions with adolescents; therefore, meta-analysis was not performed. Conclusions: While no specific outcome of the interventions was reported, all papers agreed that adolescent co-designing in ASRH interventions should occur at all stages to increase understanding of local perceptions and develop a successful intervention.
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Anastario M, FireMoon P, Rink E. Sexual risk behaviors and the legacy of colonial violence among Northern plains American Indian youth: A mixed methods exploratory study. Soc Sci Med 2020; 258:113120. [PMID: 32574888 PMCID: PMC7971236 DOI: 10.1016/j.socscimed.2020.113120] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/21/2020] [Accepted: 06/04/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In this article, we honor the tribal remembering of two Northern Plains tribes to illustrate how the legacy of colonial violence frames the way in which substance use and mental health affect sexual risk behaviors among American Indian youth on the reservation today. METHODS We used a multi-phase, mixed quantitative and qualitative methods design within a community based participatory research framework to illustrate how the legacy of colonial violence frames epidemiological links between substance use, mental health, and sexual risk behavior among American Indian youth. We conducted semistructured interviews with 29 individuals and administered questionnaires to 298 American Indian youth living in a reservation environment. RESULTS Our findings explicate how a legacy of colonial violence underlies epidemiological links between mental health and substance use with sexual risk behavior among youth. Salient facets of colonial violence included systematically altered living arrangements, the boarding school era, eroded traditional practices, and the entry of extractive industries onto native lands. DISCUSSION The colonial violence enacted against the ancestors of Northern Plains tribal peoples materializes in the health of those living on the reservation today. Community interventions, which seek to address the role of substance use and mental health in sexual risk behavior, could benefit from delineating tribal perceptions regarding the legacy of colonial violence on public health outcomes through the use of a CBPR framework.
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Affiliation(s)
| | | | - Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, MT, USA.
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8
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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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9
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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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McCarron H, Griese ER, Dippel E, McMahon TR. Cultural and Social Predictors of Substance Abuse Recovery among American Indian and Non-American Indian Pregnant and Parenting Women. J Psychoactive Drugs 2018; 50:322-330. [PMID: 29932824 PMCID: PMC6407127 DOI: 10.1080/02791072.2018.1481546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Substance abuse is especially undesirable among pregnant or parenting women (PPW). As such, there is a need to examine the factors impacting positive treatment outcomes, particularly among American Indian/Alaska Native (AI/AN) PPW, as they are seeking substance abuse treatment at rates considerably higher than the national average. This study aimed to identify the social and cultural mechanisms that support their recovery. Qualitative analyses were used to identify mechanisms used by AI and non-AI PPW in their recovery. Several differences between AI and non-AI PPW emerged. AI participants mentioned their families more often as the reason why they wanted to become or stay sober. In addition to familial support, AI participants relied on a variety of other sources for assistance in their recovery. Many of the women had difficulty defining specific aspects of their culture, especially in relation to their recovery. However, for AI PPW, many aspects of AI culture were identified as they described their recovery, suggesting the often subtle ways culture can impact everyday life. Our findings indicated that women utilized cultural supports in different ways; therefore, it is necessary to help them define their culture in ways that are meaningful in their recovery.
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Affiliation(s)
- Hayley McCarron
- Population Health Research Group, Sanford Research, 2301 E. 60 Street North, Sioux Falls, SD 57104
| | - Emily R. Griese
- Population Health Research Group, Sanford Research, 2301 E. 60 Street North, Sioux Falls, SD 57104
- Department of Pediatrics, Sanford School of Medicine at the University of South Dakota
| | | | - Tracey R. McMahon
- Population Health Research Group, Sanford Research, 2301 E. 60 Street North, Sioux Falls, SD 57104
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Stanley LR, Swaim RC, Dieterich SE. The Role of Norms in Marijuana Use Among American Indian Adolescents. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2018; 18:406-415. [PMID: 28337693 DOI: 10.1007/s11121-017-0768-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
American Indian adolescents residing on reservations report high levels of marijuana use. Understanding the relationships between normative mechanisms and marijuana use in this group can be especially important in designing effective strategies to prevent use. Participants were 3446 students identifying as American Indian in grades 7-12 across four academic years (2009-2012) from 45 schools. Multilevel logistic analysis was used to examine the relationships between lifetime, last month, and frequent marijuana use and measures of the normative environment. Descriptive and injunctive norms were distinctly and directly associated with all measures of marijuana use, with family injunctive norms showing a strong relationship to use (0.49 < OR < 0.58 for a 9th grade student). Family injunctive norms moderated the relationship between descriptive norms and lifetime and last month use (OR = 0.79 and 0.82, respectively), with higher family disapproval associated with a weaker relationship between descriptive norms and use. Anticipatory socialization was positively related to all measures of marijuana use, with the relationship stronger for lifetime and last month use than for frequent use (OR = 1.88, 1.74, and 1.30, respectively). A contextual variable of descriptive norms was related to lifetime and last month use (OR = 1.66 and 1.51, respectively) but not frequent use. These findings reinforce the importance of parental norms in reducing the likelihood of using marijuana. In addition, prevention strategies that increase the perception that healthy behaviors not involving marijuana use are an enjoyable way to socialize may be more effective in preventing occasional marijuana use.
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Affiliation(s)
- Linda R Stanley
- Tri-Ethnic Center for Prevention Research, Colorado State University, Sage Hall, 1879 Campus Delivery, Fort Collins, CO, 80523-1879, USA.
| | - Randall C Swaim
- Tri-Ethnic Center for Prevention Research, Colorado State University, Sage Hall, 1879 Campus Delivery, Fort Collins, CO, 80523-1879, USA
| | - Sara E Dieterich
- Tri-Ethnic Center for Prevention Research, Colorado State University, Sage Hall, 1879 Campus Delivery, Fort Collins, CO, 80523-1879, USA
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Griese ER, Kenyon DB, McMahon TR. Identifying sexual health protective factors among Northern Plains American Indian youth: An ecological approach utilizing multiple perspectives. AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH 2016; 23:16-43. [PMID: 27536896 PMCID: PMC5463740 DOI: 10.5820/aian.2304.2016.16] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study examined aspects of the sociocultural context in which American Indian (AI) teen pregnancy occurs, focusing specifically on protective factors for Northern Plains AI youth. Principles of community-based participatory research guided the qualitative data collection from 185 community members (focus groups with AI youth, youth parents, and elders; interviews with health care providers and school personnel) from a reservation and an urban community. Results indicated three protective systems impacted the sexual health and behaviors of AI youth: school, family, and enculturation. These findings provide a better understanding of how specific protective factors within these systems may buffer AI youth from involvement in risky sexual behaviors and work to inform culturally relevant prevention and intervention efforts.
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Rink E, FourStar K, Anastario MP. The Relationship Between Pregnancy Prevention and STI/HIV Prevention and Sexual Risk Behavior Among American Indian Men. J Rural Health 2015; 33:50-61. [PMID: 26696246 DOI: 10.1111/jrh.12166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We examined the relationship between American Indian men's attitudes toward pregnancy prevention, STI/HIV prevention, and sexual risk behavior. Attention was given to: (1) attitudes and intentions to use condoms and sexual risk behavior; (2) STI/HIV prevention characteristics and sexual risk behavior; (3) attitudes toward abstinence and monogamy and sexual risk behavior; and (4) decision-making in relationships and sexual risk behavior. STUDY DESIGN Our sample included 120 heterosexual American Indian men aged 18 to 24 living on a reservation. Data were collected during in-depth interviews. A community-based participatory research framework was used to ensure the relevancy and acceptability of the study given the sensitivity of the topic. PRINCIPAL FINDINGS Results demonstrated that attitudinal factors were associated with sexual risk behavior, particularly inconsistent condom use. Attitudes associated with consistent condom use suggested greater levels of positive dispositions toward prevention and intention to use condoms. Consistent condom use was associated with more cautious attitudes toward sex with multiple sex partners. Study results suggested that American Indian men who reported sex with multiple partners exhibited a set of attitudes and beliefs toward pregnancy prevention and STI/HIV prevention that corresponded with a disposition resulting from their behaviors, in that engaging in sexual risk behavior elevated their levels of risk perception. CONCLUSIONS Our findings suggest that heterosexual American Indian men living in rural environments need sexual and reproductive health programs and clinical services that address differing attitudes toward condom use within the context of multiple sex partners and sexual risk behavior.
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Affiliation(s)
- Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, Montana
| | - Kristofer FourStar
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana
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Jensen J, Baete Kenyon DY, Hanson JD. Preventing alcohol-exposed pregnancy among American-Indian youth. SEX EDUCATION 2015; 16:368-378. [PMID: 27429593 PMCID: PMC4942809 DOI: 10.1080/14681811.2015.1082070] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Research has determined that the prevention of alcohol-exposed pregnancies (AEP) must occur pre-conceptually with women, either by reducing alcohol intake in women planning pregnancy or at-risk for becoming pregnant, or by preventing pregnancy in women drinking at risky levels. One such AEP prevention programme with non-pregnant American Indian women is the Oglala Sioux Tribe (OST) CHOICES (Changing High-risk alcohOl use and Increasing Contraception Effectiveness Study) Programme, which shows promise in reducing AEP risk in American Indian women aged 18 or older. A community needs assessment was conducted with key informant interviews and focus groups with an emphasis on how to expand OST CHOICES. To identify interconnected themes, a content analysis methodology was used on the qualitative feedback from the focus groups and interviews. Altogether, key informant interviews were completed with 25 health and social service professionals. Eight focus groups were held with 58 American Indian participants, including adult women of child-bearing age, elder women, and adult men. Several sub-themes regarding the prevention of AEP with youth were identified, expanding the OST CHOICES curriculum into the schools, and the role of family and culture within AEP prevention.
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15
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McMahon TR, Hanson JD, Griese ER, Kenyon DB. Teen Pregnancy Prevention Program Recommendations from Urban and Reservation Northern Plains American Indian Community Members. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2015; 10:218-241. [PMID: 26550005 PMCID: PMC4606818 DOI: 10.1080/15546128.2015.1049314] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program effectiveness, few teen pregnancy prevention programs have published on recommendations for adapting these programs to address the specific needs of Northern Plains American Indian youth. We employed a mixed-methods analysis of 24 focus groups and 20 interviews with a combined total of 185 urban and reservation-based American Indian youth and elders, local health care providers, and local school personnel to detail recommendations for the cultural adaptation, content, and implementation of a teen pregnancy prevention program specific to this population. Gender differences and urban /reservation site differences in the types of recommendations offered and the potential reasons for these differences are discussed.
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Johnson KM, Dodge LE, Hacker MR, Ricciotti HA. Perspectives on family planning services among adolescents at a Boston community health center. J Pediatr Adolesc Gynecol 2015; 28:84-90. [PMID: 25850588 DOI: 10.1016/j.jpag.2014.05.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 03/23/2014] [Accepted: 05/27/2014] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE The aim of this project was to investigate adolescent perspectives on family planning services at a community-health center, with the intent to inform health center programs aimed at stemming the adolescent pregnancy rate. DESIGN This project was cross-sectional and employed mixed methods, including surveys and interviews, for the purposes of quality improvement. SETTING The project was conducted in the obstetrics and gynecology clinic at an urban community health center in Boston. PARTICIPANTS Twenty adolescent females (age 16-20) who used services at the health center. INTERVENTION Participants were individually interviewed to assess perspectives on family planning services and to identify major influences on methods of pregnancy prevention. MAIN OUTCOME MEASURE Major themes were categorized into contraceptive usage, reproductive health knowledge, adult influence and communication, barriers to contraceptive care and expectations of a family planning clinic. RESULTS All participants were sexually active and 80% had experienced pregnancy. Reproductive health knowledge was variable and in many cases limited. Concern about disapproval was a prominent barrier to going to a clinician for contraception or advice and parents were not often involved in the initial contraception discussion. Other barriers to use of contraception included forgetting to use the methods and fear of side effects. CONCLUSION We identified several potentially modifiable factors, including lack of knowledge, concern for provider disapproval and fear of side effects that may limit effective use of family planning services by adolescents. Further attention should be paid to these factors in designing and improving youth-friendly services in ob-gyn clinics.
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Affiliation(s)
- Katherine M Johnson
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA; Department of Obstetrics and Gynecology, Dimock Center, Roxbury, MA
| | - Laura E Dodge
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA
| | - Michele R Hacker
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA
| | - Hope A Ricciotti
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA; Harvard Medical School, Boston, MA; Department of Obstetrics and Gynecology, Dimock Center, Roxbury, MA.
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17
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Saftner MA, Martyn KK, Momper SL, Loveland-Cherry CJ, Low LK. Urban American Indian Adolescent Girls: Framing Sexual Risk Behavior. J Transcult Nurs 2014; 26:365-75. [PMID: 24803532 DOI: 10.1177/1043659614524789] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE The purpose of this study was to explore factors that influence urban adolescent American Indian (AI) girls' sexual risk behavior. DESIGN A qualitative study was conducted with grounded theory methodology to reveal factors and processes that influence sexual risk behavior. METHOD Talking circles, individual interviews, and event history calendars were used with 20 urban AI 15- to 19-year-old girls to explore influences on sexual risk behavior. RESULTS The generated theory-framing sexual risk behavior-describes social and structural factors and processes that influenced the girls' sexual risk behavior. The theory extends Bronfenbrenner's ecological model by identifying microsystem, mesosystem, and macrosystem influences on sexual risk behavior. DISCUSSION Urban AI girls reported similar social and structural influences on sexual risk behavior as urban adolescents from other racial and ethnic groups. However, differences were noted in the family structure, cultural heritage, and unique history of AIs. IMPLICATIONS This theory can be used in culturally responsive practice with urban AI girls.
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Affiliation(s)
| | - Kristy K Martyn
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, GA, USA
| | - Sandra L Momper
- University of Michigan School of Social Work, Ann Arbor, MI, USA
| | | | - Lisa Kane Low
- University of Michigan School of Nursing, Ann Arbor, MI, USA
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Rutman S, Taualii M, Ned D, Tetrick C. Reproductive health and sexual violence among urban American Indian and Alaska Native young women: select findings from the National Survey of Family Growth (2002). Matern Child Health J 2013; 16 Suppl 2:347-52. [PMID: 22903302 DOI: 10.1007/s10995-012-1100-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Existing data on American Indians and Alaska Natives (AI/ANs) has indicated high rates of unintended pregnancy, high-risk sexual behavior, and experiences of sexual violence. This study from the first analysis to examine AI/ANs and the urban AI/AN subgroup in the National Survey of Family Growth (NSFG) reports new findings of reproductive health and sexual violence among urban AI/AN young women. We examined 2002 NSFG data on urban AI/AN women ages 15-24 years for pregnancies/births, unintended pregnancy, sexual initiation and contraceptive use. We also examined non-voluntary first sexual intercourse among urban AI/AN women ages 18-44 years. Prevalence estimates and 95 % confidence intervals were calculated. Findings include prevalence rates of risk factors among urban AI/AN women ages 15-24 years including unprotected first sex (38 %), first sex with much older partners (36 %), three or more pregnancies (13 %) and births (5 %) and unintended pregnancies (26 %). Seventeen percent of urban AI/ANs ages 18-44 years reported experiencing non-voluntary first sex. Sixty-one percent of urban AI/AN women ages 15-24 years were not using any method of contraception. Current contraceptive methods among those using a method included: injections/implants (23 %), contraceptive pills (32 %) and condoms (25 %). Findings describe reproductive health risk factors among young urban AI/AN women and highlight the need for enhanced surveillance on these issues. Those working to improve AI/AN health need these data to guide programming and identify resources for implementing and evaluating strategies that address risk factors for this overlooked population.
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Affiliation(s)
- Shira Rutman
- Urban Indian Health Institute, Seattle Indian Health Board, Seattle, WA 98114, USA.
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Geographic variation in trends and characteristics of teen childbearing among American Indians and Alaska Natives, 1990-2007. Matern Child Health J 2013; 16:1779-90. [PMID: 22143466 DOI: 10.1007/s10995-011-0924-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
To study teen birth rates, trends, and socio-demographic and pregnancy characteristics of AI/AN across geographic regions in the US. The birth rate for US teenagers 15-19 years reached a historic low in 2009 (39.1 per 1,000) and yet remains one of the highest teen birth rates among industrialized nations. In the US, teen birth rates among Hispanic, non-Hispanic black, and American Indian/Alaska Native (AI/AN) youth are consistently two to three times the rate among non-Hispanic white teens. Birth certificate data for females younger than age 20 were used to calculate birth rates (live births per 1,000 women) and joinpoint regression to describe trends in teen birth rates by age (<15, 15-17, 18-19) and region (Aberdeen, Alaska, Bemidji, Billings, California, Nashville, Oklahoma, Portland, Southwest). Birth rates for AI/AN teens varied across geographic regions. Among 15-19-year-old AI/AN, rates ranged from 24.35 (California) to 123.24 (Aberdeen). AI/AN teen birth rates declined from the early 1990s into the 2000s for all three age groups. Among 15-17-year-olds, trends were approximately level during the early 2000s-2007 in six regions and declined in the others. Among 18-19-year-olds, trends were significantly increasing during the early 2000s-2007 in three regions, significantly decreasing in one, and were level in the remaining regions. Among AI/AN, cesarean section rates were lower in Alaska (4.1%) than in other regions (16.4-26.6%). This is the first national study to describe regional variation in AI/AN teen birth rates. These data may be used to target limited resources for teen pregnancy intervention programs and guide research.
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Spatially varying predictors of teenage birth rates among counties in the United States. DEMOGRAPHIC RESEARCH 2012; 27:377-418. [PMID: 23144587 DOI: 10.4054/demres.2012.27.14] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Limited information is available about teenage pregnancy and childbearing in rural areas, even though approximately 20 percent of the nation's youth live in rural areas. Identifying whether there are differences in the teenage birth rate (TBR) across metropolitan and nonmetropolitan areas is important, because these differences may reflect modifiable ecological-level influences such as education, employment, laws, healthcare infrastructure, and policies that could potentially reduce the TBR. OBJECTIVES: The goals of this study are to investigate whether there are spatially varying relationships between the TBR and the independent variables, and if so, whether these associations differ between metropolitan and nonmetropolitan counties. METHODS: We explore the heterogeneity within metropolitan/nonmetropolitan county groups separately using geographically weighted regression (GWR), and investigate the difference between metropolitan/nonmetropolitan counties using spatial regime models with spatial errors. These analyses were applied to county-level data from the National Center for Health Statistics and the US Census Bureau. RESULTS: GWR results suggested that non-stationarity exists in the associations between TBR and determinants within metropolitan/nonmetropolitan groups. The spatial regime analysis indicated that the effect of socioeconomic disadvantage on TBR significantly varied by the metropolitan status of counties. CONCLUSIONS: While the spatially varying relationships between the TBR and independent variables were found within each metropolitan status of counties, only the magnitude of the impact of the socioeconomic disadvantage index is significantly stronger among metropolitan counties than nonmetropolitan counties. Our findings suggested that place-specific policies for the disadvantaged groups in a county could be implemented to reduce TBR in the US.
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Benbenek MM, Garwick AW. Enablers and barriers to dietary practices contributing to bone health among early adolescent Somali girls living in Minnesota. J SPEC PEDIATR NURS 2012; 17:205-14. [PMID: 22734874 DOI: 10.1111/j.1744-6155.2012.00334.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To explore the dietary factors that contribute to bone health among first generation Somali girls and to determine the social and cultural contexts that shape these health behaviors. DESIGN AND METHODS Findings presented are from a larger, descriptive qualitative study that used a series of focus groups with four cohorts of 11- to 14-year-old Somali girls (n= 39) living in two Minnesota communities. RESULTS Cultural tradition, developmental stage, acculturation, and environment were major factors contributing to the intake of calcium and vitamin D-rich foods. PRACTICE IMPLICATIONS Findings provide the foundation for the development of culturally relevant promotion of foods rich in calcium and vitamin D.
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Rink E, FourStar K, Elk JM, Dick R, Jewett L, Gesink D. Young Native American Men and Their Intention to Use Family Planning Services. Am J Mens Health 2012; 6:324-30. [DOI: 10.1177/1557988312439226] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examines the extent to which age, fatherhood, relationship status, self-control of birth control method, and the use of birth control influence young Native American men’s intention to use family planning services. Data were collected for this study during in-depth interviews with 112 Native American men between the ages of 18 and 24 years. The mean age reported was 21. Thirty-eight percent of the young men reported having children. Almost 70% of the young men reported being in a steady relationship. Eighty-eight percent reported that it was very important that they have self-control of the type of birth control that they use. In addition, 88% of the young men reported that they would use some type of birth control within the next year to prevent a pregnancy with their partner. Logistic regression analysis indicated that as age increased, young men were less likely to seek family planning services for birth control. The young men who reported being fathers were more likely than the young men who did not report being fathers to seek family planning services for birth control. Findings from this study suggest that public health efforts to educate Native American men about family planning services are most effective in their adolescence, before they transition into young adulthood. Fatherhood may also be considered a protective factor that may increase the likelihood that young Native American men will seek family planning services for birth control. Public health efforts that address reproductive health among young Native American men may be effective with Native American men in adolescence, prior to their transition to young adulthood. Family planning services that provide outreach education and care to Native American fathers may also be effective.
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Smith PB, Realini JP, Buzi RS, Martinez M. Students' experiences and perceived benefits of a sex education curriculum: a qualitative analysis. JOURNAL OF SEX & MARITAL THERAPY 2011; 37:270-285. [PMID: 21707329 DOI: 10.1080/0092623x.2011.582433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A qualitative evaluation explored the experiences and perceived benefits of students who participated in an abstinence-plus sex education program at enrollment and conclusion. The sample included 1130 inner-city high school students, 73.7% of whom were Hispanic. Thematic analysis was used to identify main themes in responses made by students to 3 open-ended questions. The most common preparticipation request was for information about sexually transmitted infections. At program conclusion, the most common response theme involved the quality of course delivery. Students indicated that they appreciated the facilitators who allowed open conversations. The implications of these findings to sex education programs are discussed.
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Affiliation(s)
- Peggy B Smith
- Population Program, Baylor College of Medicine, Houston, Texas 77030, USA.
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24
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Lowe J. A cultural approach to conducting HIV/AIDS and hepatitis C virus education among native American adolescents. J Sch Nurs 2008; 24:229-38. [PMID: 18757356 DOI: 10.1177/1059840508319866] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This pilot study tests the feasibility of using a Talking Circle approach and measures cultural values and beliefs within a HIV/AIDS and hepatitis C virus (HCV) prevention program conducted among a Native American (Cherokee) youth population. A descriptive correlation design was used to examine the relationship between Cherokee self-reliance and HIV/AIDS and HCV knowledge, attitudes, and behaviors. The study used three questionnaires that were administered before and after the prevention program to collect data from a convenience sample of 41 students at a public high school within the boundaries of the Cherokee Nation in Oklahoma. Statistical analysis revealed immediate differences between pretests and posttests related to knowledge, attitudes, and behavioral intentions concerning HIV/AIDS and HCV and the cultural dynamic of Cherokee self-reliance.
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Affiliation(s)
- John Lowe
- Christine E. Lynn College of Nursing, Florida Atlantic University, Davie, FL, USA
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