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Kuo C, Jasczynski M, Yoo JH, Robinson JL, Reynolds K, Anoruo L, Bae K, Ka'opua LS, Chavez R, Tellei J, Aparicio EM. "I Need to Get My Culture Back": Youth and Provider Perspectives on Integrating Culturally Based Approaches into Sexual and Reproductive Health Programs for Native Hawaiian and Pacific Islander Youth Experiencing Homelessness. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:209-221. [PMID: 37566201 PMCID: PMC10764447 DOI: 10.1007/s11121-023-01573-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/12/2023]
Abstract
There is growing interest in decolonizing sexual and reproductive health (SRH) and embedding cultural practices into social and medical services in Hawai'i. Wahine ("woman") Talk is a multilevel, comprehensive SRH program for female youth experiencing homelessness (YEH) led by community health, social work, and medical providers. This study examines youth and program provider perspectives of culturally based approaches that may strengthen SRH programs. The study team conducted three focus groups and ten in-depth interviews with participating youth and program providers after the program's conclusion. Youth participants were aged 14 to 22 years (M = 18.1) and of Native Hawaiian or Pacific Islander ancestry. Interview transcripts were analyzed using structured thematic analysis. The youth described feeling estranged from their ancestral cultures and suggested incorporating multiple cultural practices to enhance their connection to community, body, and land into SRH programming for YEH. They identified several 'āina ("land")-based approaches, hands-on learning, hula, and language as possible practices to weave into the program. While youth felt estranged from their ancestral cultures, they discussed Native Hawaiian and Pacific Islander health perspectives where 'āina and relationships are considered life-sustaining. Youth and program staff stressed incorporating culture respectfully, caring for the whole person, and providing trauma-informed care. Future policy, practice, and research should consider protecting and integrating Native Hawaiian conceptions of health into SRH policy and practice and include youths' cultural identities in SRH intervention development.
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Affiliation(s)
- Charlene Kuo
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA.
| | - Michelle Jasczynski
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Jee Hun Yoo
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Jennifer L Robinson
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
| | - Katelyn Reynolds
- College of Computer, Mathematical, & Natural Sciences, Department of Biology, University of Maryland, College Park, MD, USA
| | - Lisa Anoruo
- School of Public Health, Department of Public Health Science, University of Maryland, College Park, MD, USA
| | - Kayla Bae
- School of Public Health, Department of Public Health Science, University of Maryland, College Park, MD, USA
| | - Lana Sue Ka'opua
- Thompson School of Social Work & Public Health (Retired), Department of Social Work, University of Hawai'i at Mānoa, Honolulu, HI, USA
| | - Rebecca Chavez
- Waikiki Health, Honolulu, HI, USA
- PATH Clinic and Youth Outreach, Honolulu, HI, USA
| | - Jacqueline Tellei
- Waikiki Health, Honolulu, HI, USA
- PATH Clinic and Youth Outreach, Honolulu, HI, USA
| | - Elizabeth M Aparicio
- School of Public Health, Department of Behavioral and Community Health, University of Maryland, College Park, MD, USA
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John-Henderson NA, White EJ, Crowder TL. Resilience and health in American Indians and Alaska Natives: A scoping review of the literature. Dev Psychopathol 2023; 35:2241-2252. [PMID: 37345444 PMCID: PMC10739606 DOI: 10.1017/s0954579423000640] [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] [Indexed: 06/23/2023]
Abstract
American Indians and Alaska Natives suffer from disproportionately high rates of chronic mental and physical health conditions. These health inequities are linked to colonization and its downstream consequences. Most of the American Indian and Alaska Native health inequities research uses a deficit framework, failing to acknowledge the resilience of American Indian and Alaska Native people despite challenging historical and current contexts. This scoping review is based on a conceptual model which acknowledges the context of colonization and its consequences (psychological and health risk factors). However, rather than focusing on health risk, we focus on protective factors across three identified domains (social, psychological, and cultural/spiritual), and summarize documented relationships between these resilience factors and health outcomes. Based on the scoping review of the literature, we note gaps in extant knowledge and recommend future directions. The findings summarized here can be used to inform and shape future interventions which aim to optimize health and well-being in American Indian and Alaska Native peoples.
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Affiliation(s)
- Neha A John-Henderson
- Department of Psychology, Montana State University, Bozeman, MT, USA
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA
| | - Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Tony L Crowder
- Center for American Indian and Rural Health Equity, Montana State University, Bozeman, MT, USA
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Kennedy DP, Brown RA, D'Amico EJ, Dickerson DL, Johnson CL, Malika N, Rodriguez A, Arvizu-Sanchez V. Social Networks, Cultural Pride, and Historical Loss Among Non-Reservation American Indian / Alaska Native Emerging Adults. RESEARCH SQUARE 2023:rs.3.rs-3547685. [PMID: 38045309 PMCID: PMC10690312 DOI: 10.21203/rs.3.rs-3547685/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Health disparities among American Indian/Alaska Native (AI/AN) populations in the United States are the result of historical traumas, such as colonization, forced relocation, and federal policies focused on cultural assimilation. Culturally-tailored health interventions aim to address intergenerational trauma by emphasizing cultural strengths and building positive social connections. In this article, we explore the social network characteristics of participants of the first culturally-tailored health intervention for AI/AN emerging adults (18-25) living outside of tribal lands. Participants (N = 150; 86% female) were recruited across the United States via social media and completed online egocentric network interviews prior to the start of intervention workshops. Participants' networks were diverse in composition and structure. They were primarily composed of family and friends, were people they had regular contact with, were similar age, and provided participants with support. We tested for significant associations between network characteristics, individual characteristics (age, gender, travel to reservations, speaking tribal languages, etc.) and two dependent measures: 1) cultural pride and belongingness and 2) thoughts of historical loss. Multiple regression results show that higher proportions of network members who discussed AI/AN identity with participants and having more network members who engage in traditional practices was associated with stronger cultural pride and belongingness. Higher proportions of network members having discussion of AI/AN identity with participants was also associated with more frequent thoughts of historical loss. Controlling for network factors, no individual characteristics were associated with either dependent variable. We discuss implications for the development of culturally-tailored health interventions.
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Owen MJ, Tobey M, Sundberg M. Graduate Medical Education Training and the Health of Indigenous Peoples. J Grad Med Educ 2023; 15:37-39. [PMID: 36817523 PMCID: PMC9934843 DOI: 10.4300/jgme-d-22-00967.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Affiliation(s)
- Mary J. Owen
- Mary J. Owen, MD, is a member of the Tlingit Nation, Associate Dean of Native American Health, Director, Center of American Indian and Minority Health, and Assistant Professor, Department of Family Medicine and Biobehavioral Health, University of Minnesota Medical School
| | - Matthew Tobey
- Matthew Tobey, MD, is Assistant Professor, Harvard Medical School, Massachusetts General Hospital
| | - Michael Sundberg
- Michael Sundberg, MD, is Assistant Professor, University of Minnesota Medical School
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