The Weaving Healthy Families program: Promoting parenting practices, family resilience, and communal mastery

Parenting quality, family resilience, and community resilience and support have been found to be primary protective factors for the disproportionate burden of anxiety, posttraumatic stress disorder (PTSD), substance use disorder (SUD), depression, and suicide that US Indigenous youth and adults tend to experience. The purpose of this research study was to examine pilot results for outcomes related to relational factors for Indigenous family members who participated in the Weaving Healthy Families (WHF) program (translated to Chukka Auchaffi' Natana, in the Choctaw tribal language), a culturally grounded and empirically informed program geared toward promoting wellness, family resilience, parenting practices, and community resilience while also preventing SUD and violence. This nonrandomized pre-experimental pilot intervention followed a longitudinal design, which included pre-test, a post-test, and a 6-, 9-, and 12-month post-intervention follow-up surveys. Repeated-measures regressions were utilized with generalized estimating equations (GEE) to examine changes in parenting, family resilience, and communal mastery before and after the intervention for 24 adults and adolescents (12-17) across eight tribal families. Results indicate that the overall quality of parenting improved, as measured by improved parental monitoring and reductions in inconsistent discipline and corporal punishment. We identified sex differences in positive parenting, poor monitoring, and corporal punishment, with greater decreases in these measures among males over time. Family resilience and communal mastery improved for adolescent and adult participants after the WHF program. Our results indicate promising improvements across relational, familial, and community ecological, which provide clear clinical implications.

"We have to … work for wholeness no matter what": Family and culture promoting wellness, resilience, and transcendence

Sociocultural, mental, behavioral, and physical factors are interrelated associates of chronic health conditions-such as diabetes, obesity, and cardiovascular disease-all of which are disproportionally high and drive much of the mortality and morbidity for Indigenous peoples. Indigenous worldviews conceptualize health holistically, with inseparability across social, spiritual, cultural, familial, mental, behavioral, physical, and social dimensions of wellness. Food, family, and culture are fundamental to Indigenous wellness. The purpose of this article is to use the Framework of Historical Oppression, Resilience, and Transcendence (FHORT) conceptualization of relational wellness to honor urban and rural U.S. Indigenous perspectives that highlight the intersections of family, culture, physical health, spiritual, and mental health to promote resilience and wellness. This research focused on interconnections between wellness, culture, health, and family. Thirty-one critical ethnographic interviews used a life-history approach with methodology following an Indigenous toolkit for ethical and culturally sensitive research strategies, such as building upon cultural strengths, engaging in long-term, relational commitments with communities, incorporating storytelling and oral history traditions, centering Indigenous methodologies and preferences, working with cultural insiders, and prioritizing the perspectives of Indigenous peoples. Emergent themes included: (a) roots of Indigenous wellness: cultural values promoting balance and connection; (b) practicing resilience: family transmission of health information; and (c) wholistic mental wellness and resilience, with the subtheme culture and wellness. Interventions can be developed in collaboration with tribes for optimum efficacy and cultural relevancy and can approach wellness holistically in culturally relevant ways that center foodways, culture, family, and spirituality.

"Take care of your families, take care of one another": Indigenist families and foodways

Objective

The purpose of this research was to examine how families and foodways have evolved over time and how they may present promising promotive factors for resilience, health, and wellness.

Background

Because food is central to family, social relationships, and healthy living, Indigenist foodways may promote family resilience and offset inequities.

Method

Pragmatic horizon analysis of data drawn from 31 critical ethnographic interviews on food and family in the Southeast and Northwest, including both urban and rural reservation tribal contexts, resulted in emergent themes related to food and families.

Results

Themes included (a) foodways fostering family connectedness: "The fresh vegetable is how I remember my grandpa"; (b) tight-knit extended families and communities: "The community where I grew up … everybody knew each other, so everybody … pitched in"; (c) family and community celebrations nurturing cohesion: "The family I have, I can always count on. I can trust each one of them"; and (d) families fostering healing: "Sit down and talk to somebody … that you can trust."

Conclusion

Participants explained how foodways promoted family resilience by bringing families and communities together. Indigenist foodways fostered continuity and healing through food preparation and processing and through feasts and gatherings.

Implications

Foodways were described as fundamental to family resilience and community connectedness. Subsistence fostered exercise, eating locally sourced foods, and family resilience. Interventions are needed to promote Indigenist foodway sovereignty while first understanding how culture, history, and food inform wellness and community well-being.

Is Self-Care a Stand-In for Feminized Social Privilege? A Systematic Review of Self-Care Facilitators and Barriers to Self-Care Practices in Social Work

PURPOSE

The purpose of this systematic review is to fill the gap in a critical understanding of peer-reviewed empirical research on self-care practices to identify structural, relational, and individual-level facilitators and barriers to self-care practices in social work.

METHOD

We followed the preferred reporting items for systematic reviews and meta-analysis for this systematic review of peer-reviewed quantitative and qualitative empirical research articles focusing on self-care in social work among adult social work practitioners and students.

RESULTS

Twenty-one articles related to empirical studies of self-care were identified in the systematic review process with samples of social work practitioners (n = 15), social work students (n = 3), and social work educators (n = 3).

DISCUSSION

Social workers engaged in self-care practices are more likely to be healthy, work less, be White, and have higher socioeconomic professional status and privilege, indicating current conceptualizations of self-care may not be accessible and contextually and culturally relevant for many social workers.

CONCLUSION

Overwhelmingly, results indicated social workers reporting greater sociostructural, economic, professional, and physical health privilege engaged in more self-care. No articles directly assessed institutional factors that may drive distress among social workers and clients. Rather, self-care was framed as a personal responsibility without integration of feminized and racialized inequities in a sociopolitical and historical context. Such framings may replicate rather than redress unsustainable inequities experienced by social workers and clients.

Developing the Weaving Healthy Families Program to Promote Wellness and Prevent Substance Abuse and Violence: Approach, Adaptation, and Implementation

Family prevention programs that enhance mental health, wellness, and resilience-while simultaneously addressing violence and alcohol and other drug (AOD) abuse-among Indigenous families are scarce. This gap in culturally grounded and community-based programs creates a critical need to develop and evaluate the efficacy of such prevention programs. This article fills this gap, with the purpose of describing the structure and content of the Weaving Healthy Families (WHF) program, a culturally grounded and community-based program aimed at preventing violence and AOD use while promoting mental health, resilience, and wellness in Indigenous families. The focus then turns to how to approach this process of developing and implementing the program in a culturally grounded and community-based way.

"It's Always About Sharing, and Caring, and Loving, and Giving": Decolonized and Transcendent Indigenist Foodways Fostering Health and Resilience

Centuries of historical oppression have targeted and undermined Indigenous foodways, which fundamentally disrupts the culture and wellness, yet decolonized, resilient, and transcendent Indigenist practices persist. The purpose of this research was to use the framework of historical oppression, resilience, and transcendence (FHORT) to understand foodway practices among Indigenous Peoples. Given a limited understanding of how foodways may promote health and wellness the focal research questions for this critical ethnographic inquiry were: (a) How do participants describe Indigenist foodways? (b) How do Indigenist foodways reflect decolonized values and practices? and (c) How may Indigenist foodways be promotive for health and wellness? Data were drawn from 31 participants across a rural, reservation-based Southeast (SE) region and an urban Northwest (NW) region. Reconstructive data analysis revealed the following emergent themes: (a) Indigenous Values of Generosity Expressed Through Foodways: "It's Always About Sharing, and Caring, and Loving, and Giving"; (b) Gardening, Subsistence, and Food Sharing: "You Bring Enough for Everybody to Share"; (c) Decolonized Feasts and Foodways: "Everybody Pitch in and Help as Much as They Can." Despite centuries of historical oppression, participants reported decolonized values, worldviews, and foodways that reflected unity, cooperation, sharing, and social cohesion and caring, which were promotive factors for family resilience, health, and cultural identification. This research provides promising pathways about how Indigenist foodways remain salient in daily and cultural life, reflect decolonized values and practices, and may be promotive for health and wellness within the natural world.

Centering Historical Oppression in Prevention Research with Indigenous Peoples: Differentiating Substance Use, Mental Health, Family, and Community Outcomes

The purpose of this pilot study was to understand how historical oppression relates to changes in outcomes for people who participate in the culturally grounded Weaving Healthy Families (WHF) program (i.e., alcohol and drug use, symptoms of anxiety, parenting practices, and communal mastery [CM]). This nonexperimental and longitudinal design used repeated measures regression analysis and generalized estimating equations (GEE) to examine postintervention changes according to reported levels of historical oppression among 24 participants in eight families. How do postintervention changes differ for WHF participants reporting lower and higher levels of historical oppression? Results indicated that participants reporting lower historic oppression reported greater postintervention improvements as indicated by declines in alcohol use, anxiety, and poor parental monitoring. All participants reported increases in CM, regardless of the level of historical oppression. Given historical oppression drives psychosocial conditions, such as substance abuse, mental health, and family challenges, settler colonial oppression must be addressed within social service interventions. Social service providers must work redress historical oppression rather than replicate them. The WHF program holds promise to center structural determinants in social service programs. Future inquiries assessing longitudinal changes in perceptions of historical oppression change and how they are associated with psychosocial outcomes are needed.

"I don't remember any of us … having diabetes or cancer": How historical oppression undermines indigenous foodways, health, and wellness

Past and present structures of settler colonial historical oppression aimed to erase and replace Indigenous peoples have profoundly disrupted U.S. Indigenous foodways. The purpose of this article is to use the Indigenous Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to understand U.S. Indigenous peoples' experiences and perceptions of how (a) foodways have changed within the context of settler colonial historical oppression and (b) these changes have affected wellness and cultures of Indigenous peoples. Critical ethnographic analysis focused on data from 31 interviews with participants from a rural Southeast reservation and a Northwest urban context. Results revealed participants' descriptions of changing foodways situated in a system of historical oppression, with themes including (a) historical oppression and changing values and foodway practices; (b) settler colonial governmental programs interrupting foodways through commodities and rations; and (c) changing foodway practices: from homegrown and homemade to fast food and premade. Participants described the aftermath of settler colonial governmental policies and programs undermined foodways, connectedness, cultural knowledge, family and interpersonal relationships, ceremonies, and outdoor activities-all of which promote health and wellness. To redress historical oppression, including settler colonial governmental policies, decolonized decision-making, foodways, and Indigenous food sovereignty are recommended as approaches to inform policy and programming that affirms Indigenous values and worldviews.

"We were always doing something outside. … I had a wonderful, wonderful life": U.S. Indigenous peoples' subsistence, physical activity, and the natural world

Obesity tends to be higher, whereas physical activity (PA) tends to be lower for U.S. Indigenous peoples, which drives chronic health problems and mortality. Historical oppression and nutritional colonialism have disrupted Indigenous peoples' subsistence and concomitant PA. The purpose of this research is to use the framework of historical oppression, resilience, and transcendence (FHORT) with 31 participants in a critical ethnography identifying past and present forms of PA. By examining universal themes across two tribal contexts-a Southeast reservation tribal context and an urban Northwestern context-important knowledge about promising forms of PA can inform culturally relevant and effective interventions to promote health and prevent obesity and chronic health problems. Reconstructive thematic qualitative analysis resulted in the following themes: (a) Family-Centered Physical Activity: "The Kids Would … Follow Along, Dropping Seeds and Covering it … the Seeds Grew"; (b) Staying Active in the Natural World: "When I Would Go Home [from boarding school] in the Summertime, That's When … We'll Be Back Being an Indian"; (c) Staying Active through Culture: "The Traditional Dancing … [is] a Form of Exercise"; (d) Mental Wellness in Nature: "It Seemed Like Just Sitting Out There Makes You Feel Better"; and (e) Sports and Competitions Fostering PA: "A lot … Prefer Playing Softball, Basketball, Volleyball, Nowadays". Results highlighted how participants preferred and participated in subsistence and PA growing up, how this had evolved over time, and how being outside in nature contributed to a sense of wellness and overall health.

"Why I Stayed in That Relationship": Barriers to Indigenous Women's Ability to Leave Violent Relationships

Indigenous women in the United States are among the most vulnerable to intimate partner violence (IPV), which has reached endemic levels. The purpose of this qualitative inquiry was to understand contextual factors and barriers to becoming liberated from violence. Reconstructive analysis of data from a critical ethnography with a sample of 231 women across two tribes who described IPV relationships identified the following themes: controlling relationships, losing sense of priorities, using children, socioeconomic stress, family pressures, and restricting relationships. Results revealed these tactics, which parallel those used in the patriarchal colonialism of historical oppression, impeded women's liberation from relationships.

"We've Already Endured the Trauma, Who is Going to Either End that Cycle or Continue to Feed It?": The Influence of Family and Legal Systems on Native American Women's Intimate Partner Violence Experiences

Native American (NA) women experience higher rates of intimate partner violence (IPV) compared to other U.S. racial/ethnic groups, yet previous research has not sufficiently examined the complex determinants shaping their IPV experiences. This research explores the interplay of family networks and legal systems influencing NA women's IPV experiences. Data were collected through in-depth individual and group interviews with 42 NA survivors and 41 health/social service providers from July 2016 to June 2017 in NA communities from three different U.S. regions. We used Grounded Theory to develop emergent themes from the data, focusing on system-level risk and protective factors of women's of IPV experiences. In terms of family systems, participants indicated that NA communities were comprised of highly influential and interwoven family systems, making them powerful sources of support for both survivors and their partners who use violence. Participants described how intergenerational violence exposures contributed to the normalization of violence. In terms of legal systems, participants described inconsistent consequences for abusers of NA women, insufficient protection from legal systems, and manipulation of jurisdictional complexities. Interactions between family and legal systems influenced decision-making and outcomes. Family and community-based approaches, and the incorporation of traditional language and cultures, are needed to promote healing. Our findings reflect the complex ways that family and legal systems shape NA women's IPV experiences. Results provide insight into how NA women interact with and navigate these systems when experiencing IPV and how these systems impact decision-making and the ability to be safe from IPV. Research is needed to advance understanding of the inter-relationships between intergenerational trauma, family systems, and legal systems on IPV survivors' mental health and wellness. To make meaningful change, further research examining IPV from an interdisciplinary perspective that explores the interplay of social determinants of health inequities is needed.

"You Can Get Away with Anything Here… No Justice at All"- Sexual Violence Against U.S. Indigenous Females and Its Consequences

Sexual violence against Indigenous women has long been used as a tool of colonial violence and conquest. As a contemporary form of historical oppression that may drive associated health and mental health inequities, Indigenous women in the United States experience sexual violence at greater levels than the general population and at and twice the rate of Indigenous men. We use the Indigenous framework of historical oppression, resilience, and transcendence (FHORT) to understand Indigenous women's experiences of sexual violence and how it differentiates across ecological outcomes related to health and wellness. This exploratory sequential multimethod study with 563 participants (n = 436 qualitative and n = 127 quantitative survey participants) qualitatively explores how Indigenous peoples describe sexual violence and quantitatively investigates key differences across ecological outcomes of wellness related to sexual violence, including alcohol use and post-traumatic stress disorder (PTSD). Results indicated that all participants (100 percent) who reported sexual violence were women. Thematic analysis of qualitative results revealed the themes related to familial, non-familial, and the historical oppression of a lack of accountability for perpetrators. Quantitative t-Tests results revealed that experiencing sexual violence was associated with significant differences across ecological dimensions of wellness including (a) structural: higher historical oppression, historical loss, oppression, and discrimination; (b) relational: higher adverse childhood experiences and stressful life events and lower family resilience and social support; (c) spiritual: lower spiritual-well-being and life satisfaction; and (d) psychological/behavioral: higher levels of alcohol use, PTSD, and lower levels of psychological resilience. Thus, sexual violence profoundly affected Indigenous women.

"When You Come Together and Do Everything, It'll be Better for Everybody": Exploring Gender Relations Among Two Southeastern Native American Tribes

Prior to the imposition of patriarchal colonial norms, Native American (NA) gender relations were characterized as complementary and egalitarian; however, little research has explored gender relations within NA communities today. This study used a community-based critical ethnography to explore contemporary NA gender relations with a purposive sample of 208 individuals from the "Coastal Tribe" and 228 participants from the "Inland Tribe." After participant observation, interviews, and focus groups were conducted, a collaborative approach to reconstructive analysis was used to identify themes in the data. Within these communities, gender relations tended to reflect egalitarian and cooperative but gendered norms, and participants provided examples of how tribal members are transcending patriarchal colonialism. Through the lens of the Framework of Historical Oppression, Resilience, and Transcendence, we theorize how these gender norms may protect families from risks associated with historical oppression and promote family resilience with implications for research, practice, and policy.

'Marriage is Going to Fix It': Indigenous Women's Experiences with Early Childbearing, Early Marriage and Intimate Partner Violence

Intimate partner violence (IPV), early childbearing (ECB) and early marriage (EM) are interconnected to the historical oppression of patriarchal colonialism imposed upon Indigenous peoples throughout the world by colonising nations, such as the UK. The artefacts of colonial oppression persist in both colonising nations and those that have been colonised through social norms of patriarchal oppression perpetuated upon women with far-reaching consequences. Indigenous women of the US experience higher rates of IPV, ECB and EM than any other ethnic group-which pose risks to women's physical, psychological, socioeconomic and educational status. The purpose of this study is to explore Indigenous women's experiences with ECB and EM through a critical ethnography with two US tribes. Through reconstructive analysis the following themes emerged: (i) ECB as a Precursor to Marriage; (ii) Unequal and Overburdened Marriages; (iii) ECB, EM and IPV; and (iv) Continued Harmful Effects of Multiple Abusive Relationships. Indigenous women's experiences of ECB and EM are connected to patriarchal historical oppression that systematically dehumanises and oppresses Indigenous women, who were once treated with respect and esteem. Decolonisation and re-visualisation to promote the status of women and girls are needed to offset women's constrained wellness, socio-political status and safety.

"It's in the family circle": Communication promoting Indigenous family resilience

OBJECTIVE

We use the Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to investigate the framework's core concept of family resilience and related protective and promotive factors that contribute to greater resilience, namely communication.

BACKGROUND

Scant research has examined communication in Indigenous families; yet general research suggests that family communication is a prominent aspect of family resilience.

METHODS

In this exploratory sequential mixed-methods study with data from 563 Indigenous participants (n = 436 qualitative and n = 127 quantitative survey), thematic reconstructive analysis was used to qualitatively understand participants' experiences of family communication and quantitatively examine protective factors for family resilience.

RESULTS

The following themes related to family communication as a component of family resilience emerged from qualitative analysis: "It's in the Family Circle": Discussing Problems as a Family with the subtheme: Honesty between Partners; (b) "Never Bring Adult Business into Kids' Lives": Keeping Adult Conversations Private; and (c) "Trust Us Enough to Come to Us": Open Communication between Parents and Children. Regression analysis indicated that higher community and social support, relationship quality, and life satisfaction were associated with greater family resilience.

CONCLUSIONS

Positive communication practices are a strong component of resilience, healthy Indigenous families. Promotive factors at the community (social and community support), relational (relationship quality), and individual (life satisfaction) levels positively contribute to Indigenous family resilience.

IMPLICATIONS

Clinical programs providing practical tools to foster healthy communication - both about difficult topics as well as positive topics - are promising avenues to foster resilience.

"It just took something from me": A mixed-methods examination of intimate partner violence victimization and perpetration among U.S. Indigenous peoples

OBJECTIVE

Indigenous peoples of the United States experience disproportionate rates of intimate partner violence (IPV). The framework of historical oppression, resilience, and transcendence (FHORT) was used to understand risk factors for IPV victimization and perpetration.

METHOD

In this exploratory sequential mixed-methods study, data were collected with 436 participants in the qualitative portion and 127 participants in the quantitative portion. After listwise deletion of missing variables, 117 participants were included in the main analyses. Thematic reconstructive analysis was used to qualitatively investigate how Indigenous peoples describe IPV victimization. T-test and regression analyses examined the following risk factors for IPV victimization and perpetration: (a) perceived oppression, (b) adverse childhood experiences (ACEs), (c) alcohol and other drug (AOD) abuse, (d) posttraumatic stress disorder (PTSD), (e) anxiety, (f) younger age, and (g) female gender.

RESULTS

Qualitative results revealed ACE, infidelity, and AOD abuse were frequently mentioned among IPV victimization for participants, with women experiencing more severe violence. Quantitative results indicated PTSD and IPV victimization were higher among women. Oppression, ACE, AOD abuse, PTSD, and female gender were risk factors for victimization, whereas younger age, anxiety, and alcohol use were risk factors for perpetration.

CONCLUSIONS

Indigenous peoples in these samples experienced rampant IPV, which was exacerbated and triggered by alcohol, drug use, and infidelity. To prevent IPV for adults, it is germane to prevent exposure to violence and substance abuse across the life course. Family-focused and culturally grounded interventions that focus both on AOD abuse, emotional regulation, and violence prevention are recommended. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

"I Have to Watch Them Closely": Native American Parenting Practice and Philosophies

One of many ways that Native American (NA) families demonstrate resilience is by parenting children in some of the most adverse contexts in U.S. society. We use the framework of historical oppression, resilience, and transcendence (FHORT) in a critical ethnography to qualitatively explore the parenting philosophies and practices that NAs use to protect children from the risks of an oppressive context. Data were drawn from 436 members of two Southeastern NA tribes. A team-based critical ethnographic data analysis approach was used to analyze these findings, revealing the following themes: (a) "Your Kids Come First": Prioritizing Children's Needs; (b) "They Should Enjoy their Childhood": Sheltering Children from Family Stressors; (c) "I Have to Watch Them Closely": Closely Monitoring Children; and, (d) "There's No Drinking at My House": Preventing Children's Exposure to Substance Abuse. Results indicate that NA parents adopt child-centric mindsets and use a number of positive practices to protect their children from the potentially harmful environments created through historical oppression.

"A Dad Can Get the Money and the Mom Stays at Home": Patriarchal Gender Role Attitudes, Intimate Partner Violence, Historical Oppression, and Resilience Among Indigenous Peoples

Research has shown that gender role attitudes influence a number of health-related outcomes, including intimate partner violence (IPV). Yet the gender role attitudes of Indigenous peoples - a population that experiences persistent health and violence disparities - have received scant scholarly attention. Using the Framework of Historical Oppression, Resilience, and Transcendence (FHORT), the purpose of this mixed methodology was to qualitatively explore U.S. Indigenous peoples' gender role attitudes and quantitatively examine how key social determinants of health, including IPV perpetration, historical oppression, and resilience, relate to gender role attitudes. This research integrates qualitative and quantitative data from two Southeastern tribes with a total of 563 unique data sources. Regression analysis revealed male sex and IPV victimization were associated with higher patriarchal gender role attitudes, while historical oppression and resilience were associated with lower patriarchal gender role attitudes. Resilience was also associated with lower "victim blaming." Ethnographic team-based data analysis methods revealed qualitative themes of patriarchal gender role attitudes and gendered socialization processes. This work highlights how key aspects of the FHORT might explain Indigenous peoples' patriarchal gender role attitudes, suggesting the need to redress historical oppression and patriarchal roles through decolonization.

"She's the Center of My Life, the One That Keeps My Heart Open": Roles and Expectations of Native American Women

Historically, Native American (NA) mothers have proven essential to the survival of their families and communities, yet scant research has examined their roles today. Current gender roles in NA communities are influenced by historical oppression (both historic and contemporary forms) that acted to reverse matrilineal gender norms in favor of patriarchy. The present study sought to explore norms and expectations for women among two NA tribes located in the southeastern region of the United States. The framework of Historical Oppression, Resilience and Transcendence (FHORT), Hill-Collins's concept of "motherwork," and a framework of reproductive justice were used to frame the study and interpret findings. This critical ethnography included data from field notes, semistructured interviews, and focus groups. Reconstructive analysis, a specific type of thematic qualitative analysis for critical ethnographies, was used to interpret data. Participants from both tribes described themes related to the expectations and roles of mothers. These expectations included themes of (a) mothers as caretakers, (b) mothers as the centers of family and role models, (c) women to prioritize family over economic and educational aspirations, and (d) decolonizing norms for mothers. While historical oppression and patriarchal norms have constrained and regulated expectations for motherhood and the domestic roles of NA women, these findings also highlight how women decolonize these norms and find ways to reclaim their power through their roles as mothers.

Weaving Healthy Families Program: Promoting Resilience While Reducing Violence and Substance Use

PURPOSE

We examine pilot results for the culturally adapted Weaving Healthy Families (WHF) program to promote resilience and wellness while preventing substance abuse and violence among Native American (NA) families.

METHODS

Results were drawn from paired sample t tests and analyses of variance (ANOVA) with a convenience sample of 24 adults and adolescents from eight NA families (pretest, posttest, and, where available, 6-month postintervention).

RESULTS

Along with substance abuse reduction and prevention, t test results indicated reductions in (a) adult depressive symptoms and improvements in adult conflict resolution and health behaviors; (b) adolescent wellness; and (c) adult and adolescent resilience, communal mastery, social support, and sugar-sweetened beverage consumption. ANOVA tests revealed reductions in adult psychological and physical violence and improvements in adult and adolescent family resilience, family environment, and emotional regulation.

CONCLUSIONS

Results reveal promising preliminary results for the WHF program to promote resilience and thriving while reducing risk for substance abuse and violence in NA families.

American Indian Alcohol Use from a Sex-Specific Wellness Approach: Exploring Its Associated Physical, Behavioral, and Mental Risk and Protective Factors

PURPOSE

The top causes of death for American Indians (AIs), including heart and liver disease, are associated with alcohol use. Using the culturally based Framework of Historical Oppression, Resilience, and Transcendence (FHORT), the purpose of this article was to examine AI alcohol use from a sex-specific wellness approach, exploring its associated physical, behavioral, and mental risk and protective factors.

METHOD

Data were drawn from a cross-sectional survey with 479 AI adults in South Dakota. We employed a series of multiple hierarchical regression analyses to assess the associations of demographic (sex, age, marital status, income, and educational attainment), physical (Body Mass Index and cardiovascular risk), behavioral (smoking and health self-efficacy) and mental (depressive symptoms) factors with alcohol use.

RESULTS

Results indicated that surveyed males tended to drink three times that of females, and depressive symptoms were associated with higher levels of alcohol use.

DISCUSSION

This study highlights the need to examine AI alcohol use with sex in mind.

Family: The Bedrock of Support for American Indian Women Cancer Survivors

Cancer disparities among American Indian (AI) women are alarming, yet a dearth of research focuses on the role of family support for such women. The purpose of this research was to examine the composition of AI women cancer survivors' family support networks and the types of support that they provided. We used a qualitative descriptive methodology with 43 AI women cancer survivors and qualitative content analysis, which indicated that 38 participants (approximately 90%) reported that their families provided integral and varied forms of support, especially instrumental support throughout cancer experiences. Families were the bedrock of support for AI women cancer survivors.

American Indian Women Cancer Survivors' Spiritual and Religious Coping Practices

Despite AI women's cancer disparities being a public health concern, a dearth of research on this populations' spiritual coping poses a barrier to redressing such disparities. The purpose of this article was to explore AI women cancer survivors' spiritual and religious coping. This qualitative descriptive study included a sample of 43 AI women cancer survivors. Qualitative content analysis revealed that 93% of AI women cancer survivors used a variety of AI spiritual coping, religious coping, and/or a mixture of the two. Results reveal the prevalence of AI spiritual coping, with traditional AI spiritual practices being particularly common.

Risk and protective factors for symptoms of depression and anxiety among American Indians: Understanding the roles of resilience and trauma

OBJECTIVE

Depression and anxiety are comorbid conditions that are disproportionately high among American Indians (AIs) or Alaska Natives. The purpose of this study was to identify potential risk (e.g., low income, intimate partner violence [IPV], adverse childhood experiences [ACEs]) and protective factors (e.g., family resilience, social and community support) related to symptoms of depression and anxiety among AI adults.

METHOD

As part of larger exploratory sequential mixed-methods research, the study focused on survey data with 127 AI adults from two Southeastern tribes (n = 117 when missing data were removed). We used the following three-stage hierarchical regression to understand factors related to depressive and anxiety symptoms: (a) demographics, including income; (b) ACEs and IPV; and (c) family resilience, along with family and community support.

RESULTS

Many participants experienced elevated levels of clinically significant symptoms of depression and anxiety (15% and 20%, respectively). Results indicated lower income was associated with higher depressive and anxiety symptoms. IPV and ACE variables were positively associated with depressive and anxiety symptoms. Family resilience was negatively associated with symptoms of anxiety and depression. Social and community support were associated with symptoms of anxiety.

CONCLUSIONS

The findings provide strong preliminary support for the role of family protective and promotive factors in offsetting symptoms of anxiety and depression. This is contrary to most models of interventions for anxiety and depression focusing on individual psychotherapy rather than promoting family resilience or involvement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Why Are So Many Indigenous Peoples Dying and No One Is Paying Attention? Depressive Symptoms and "Loss of Loved Ones" as a Result and Driver of Health Disparities

Indigenous peoples have not only experienced a devastating rate of historical loss of lives, they are more likely to experience mortality disparities. The purpose of this article is to examine Indigenous women's lived experiences of grief and loss in two Southeastern tribes and the relationship between depressive symptoms and recent loss of a loved one. Our exploratory sequential mixed-methods research was informed by the Indigenous based Framework of Historical Oppression, Resilience, and Transcendence (FHORT). We summarized key qualitative themes from ethnographic data from 287 female participants across the two tribes, collected through focus groups, family interviews, and individual interviews. We then quantitatively examined how these themes predicted depressive outcomes among 127 respondents. Specifically, we examined associations between depressive symptoms and components of historical oppression-historical loss, loss of lives, and the presence of PTSD symptoms-along with resilience and transcendence.

What's love got to do with it? "Love" and Alcohol Use among U.S. Indigenous Peoples: Aligning Research with Real-world Experiences

This research examines how Indigenous families report experiences of love (a component of family resilience) and its association with urgent health disparity of alcohol abuse. This exploratory mixed-methods first identified emergent results from qualitative data (n=436), which was then explored with follow-up and quantitative data (n =127) from a sample of Indigenous families in two Southeastern tribes. Love was a highly salient qualitative theme and component of family resilience. Quantitative results revealed cross-generational changes in family resilience, which was negatively associated with alcohol use. Current families may be transcending the effects of historical oppression and expressing love and family resilience.

Mental, Physical and Social Dimensions of Health Equity and Wellness among U.S. Indigenous Peoples: What is Known and Next Steps

This special issue and introduction focuses on promoting health equity and addressing health disparities among Indigenous peoples of the United States (U.S.) and associated Territories in the Pacific Islands and Caribbean. We provide an overview of the current state of health equity across social, physical, and mental health domains. In Part 1 of the special issue, we trace promotive, protective, and risk factors related to Indigenous health equity. Part 2 of the special issue describes interventions that address and promote wellness, providing promising pathways to achieving and transcending health equity.

The Historical Oppression Scale: Preliminary conceptualization and measurement of historical oppression among Indigenous peoples of the United States

Indigenous peoples of the United States are distinct from other ethnic minorities because they have experienced colonization as the original inhabitants. Social and health disparities are connected to a context of historical oppression-the chronic, pervasive, and intergenerational experiences of oppression that, over time, may be normalized, imposed, and internalized into the daily lives of many Indigenous peoples (including individuals, families, and communities). As part of the critical Framework of Historical Oppression, Resilience, and Transcendence (FHORT), in this article, we introduce the Historical Oppression Scale (HOS), a scale assessing internalized and externalized oppression. Our study reports on survey data (N = 127) from a larger convergent mixed-methodology study with scale items derived from thematic analysis of qualitative data (N = 436), which informed the resultant 10-item scale. After six cases were removed from the 127 participants who participated in the quantitative component to the study due to missing data across two tribes, the sample size for analysis was 121. Confirmatory factor analysis testing of the hypothesized unidimensional construct indicated acceptable model fit (X² = 58.10, X2/df= 1.94, CFI = .98, TLI = .97, RMSEA = .088, 90% CI = .05, .12). Reliability of the 10-item scale was excellent (α = .97) and convergent and discriminant validity were established. The HOS explicates complex associations between historical oppression and health and social disparities and may be an important clinical and research tool in an understudied area.

Community-Engaged and Culturally Relevant Research to Develop Behavioral Health Interventions with American Indians and Alaska Natives

American Indians and Alaska Natives experience pervasive mental, behavioral, and physical health disparities, yet access to culturally relevant and evidenced-based programs (EBPs) are severely limited. The purpose of this research is to describe the process of conducting a rigorous and culturally sensitive research approach, which was used to inform the development of a family-based substance abuse and violence prevention program that promotes resilience. The focus of this article is on the process of this development, rather than the intervention itself. We utilize a convergent mixed-methods design with distinct tribes in the Southeast that included 436 research participants across individual, family, and focus group interviews, field notes and existing data, and a quantitative survey (n = 127). This community-engaged, culturally sensitive, and rigorous research methodology provides a road-map for developing culturally relevant interventions.

Hurricanes and Indigenous Families: Understanding connections with discrimination, social support, and violence on PTSD

The purpose of this article is to use the culturally grounded Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to examine (a) the experiences and impacts of hurricanes on Indigenous (i.e., Native American) family members in the Gulf Coast and (b) to identify how experiencing hurricanes and natural disasters, family and community support, adverse childhood experiences (ACE), discrimination and intimate partner violence (IPV) may be related to post-traumatic stress disorder (PTSD) among two Southeastern tribes. Results were drawn from a convergent mixed-methodology design, which incorporates ethnographic qualitative data and a culturally grounded quantitative follow-up survey. Thematic analysis of qualitative data with 208 participants from a coastal Indigenous community revealed several emergent themes, namely (a) the Impact of Federal Recognition on Hurricane Affected Communities; (b) Rapidly Changing Landscape, Lives, and Communities; and (C) Family and Personal Effects of Hurricane Experiences. Descriptive and hierarchical regression analysis of 127 participants across two Southeastern tribes indicate that many participants frequently thought of losses from hurricanes and disasters and that over one-third of the sample met the criteria for clinically significant PTSD. Regression results affirmed the independent effects of hurricane experiences, ACE, community and family support as they relate to PTSD; yet IPV and discrimination were the strongest predictors of PTSD. Results reveal the extensive repercussions of hurricanes on Indigenous families of the Southeast, which are inseparable from and exacerbated by the insidious historical oppression, including discrimination, already experienced by these groups.

Distribution and role of Kv3.1b in neurons in the medial septum diagonal band complex

The medial septum diagonal band complex (MS/DB) projects via cholinergic and GABAergic pathways to the hippocampus and plays a key role in the hippocampal theta rhythm. In the MS/DB we have previously described a population of fast spiking GABAergic neurons that contain parvalbumin and mediate theta frequency activity in vitro. The Kv3.1 potassium channel is a delayed rectifier channel that plays a major role in fast spiking neurons in the CNS, and has previously been localized in the MS/DB. To determine which cell types in the MS/DB express the Kv3.1b ion channel subunit, transgenic mice in which the expression of GABAergic and glutamate markers are associated with the expression of green fluorescent protein (GFP; GAD67-GFP and VGluT2-GFP mice, respectively) were used for immunofluorescence and axonal tract tracing. Electrophysiological studies were also carried out on rat MS/DB slices to examine the role of the Kv3.1 channel in theta frequency oscillations. The results for the MS/DB were as follows: (1) cholinergic cells did not express GFP in either GAD67-GFP or VGluT2-GFP mice, and there was GAD67 immunoreactivity in GFP-positive neurons in GAD67-GFP mice and in a small proportion (6%) of GFP-positive neurons in VGluT2-GFP mice. (2) Kv3.1b immunofluorescence was associated with the somata of GABAergic neurons, especially those that contained parvalbumin, and with a minority of glutamatergic neurons, but not with cholinergic neurons, and with GABAergic axonal terminal-like processes around certain GABAergic neurons. (3) Both Kv3.1b-positive and -negative GABAergic neurons were septo-hippocampal, and there was a minor projection to hippocampus from VGluT2-GFP neurons. (4) Kainate-induced theta oscillations in the MS/DB slice were potentiated rather than inhibited by the Kv3.1 blocker 4-aminopyridine, and this agent on its own produced theta frequency oscillations in MS/DB slices that were reduced by ionotropic glutamate and GABA receptor antagonists and abolished by low extracellular calcium. These studies confirm the presence of heterogeneous populations of septo-hippocampal neurons in the MS/DB, and suggest that presence of Kv3.1 in the GABAergic neurons does not contribute to theta activity through fast spiking properties, but possibly by the regulation of transmitter release from axonal terminals.