American Indian and Alaska Native Mental Health Research最新文献

Gardening for Health Utilizing Traditions (GHUTS) is a new diabetes prevention intervention for urban American Indian and Alaska Native (AI/AN) adults receiving mental health treatment in Los Angeles County. The two main objectives of this study are to: 1) further our understanding of diabetes prevention and the role of gardening for urban AI/AN adults receiving mental health treatment and 2) finalize the development of GHUTS. To inform the feasibility of the intervention and to gain perspective, three focus groups were conducted among urban AI/AN adults receiving mental health treatment (n = 7), providers who serve urban AI/AN people (n = 7), and the GHUTS Community Advisory Board (n = 5). Three overarching conceptual themes emerged: 1) Diabetes is an important issue among urban AI/AN people receiving mental health treatment, 2) AI/AN traditional practices have an important role in diabetes prevention among urban AI/AN adults receiving mental health treatment, and 3) Gardening is beneficial for AI/AN people. Feedback on the GHUTS curriculum featured diabetes education, cultural elements, concerns specific to AI/AN people in Los Angeles County, cooking, physical exercise and diet, prayer and mindfulness, community sharing, and field trips. This study highlights the process of developing a community-grounded diabetes prevention intervention for urban AI/AN adults receiving mental health treatment.

American Indian and Alaska Native (AI/AN) youth have the highest commercial tobacco smoking rate of any group in the United States. Unified by the aim to reduce AI/AN youth commercial tobacco use, six separately funded tobacco prevention programs serving Southern California tribes formed the Southern California Tribal Tobacco Coalition (SCTTC). Since joining forces, the SCTTC has hosted various activities and events that encourage community involvement, youth leadership, and commitment to tradition. The SCTTC's pinnacle event, the annual Inter-Tribal Tobacco Prevention Youth Summit, is an inspiring example of the organization's collaborative efforts, as it features youth- and elder-led activities and presentations by local tribal members. These community events have grown in participation from year to year and are widely supported by the surrounding AI/AN communities. This paper includes narratives from several coalition members, including youth activity organizers, that showcase the power of collaboration through the SCTTC's partnership and its success to date. The purpose of this paper is to share the SCTTC's positive impact in Southern California tribes and encourage similar programs across the nation to amplify their program impacts by forming a coalition of their own and embracing youth-led interventions.

This article releases the Gathering of Native Americans (GONA) Fidelity Tool to the public. The paper describes the methods in the development of the GONA Fidelity Tool and how it is used in planning, implementing, evaluating, and in further tailoring the GONA process more precisely to the community's needs and strengths. Development and revision of the tool occurred over 10 years with participation and input from 7 Urban Indian Health Organizations funded under Title V of the Indian Health Care Improvement Act, using the tool to advance local GONAs across the state of California. Participating organizations used the tool in partnership with Indigenous evaluators to measure GONA implementation. Process evaluations were conducted to support tool advancements over time and an Annual GONA Training of Facilitators provided a forum for consensus building of GONA best practices for tool revisions. Results indicate that the tool is useful in the planning, implementation, and quality improvement to advance local GONAs over time. The most effective use of the tool is when the items are adapted to the local culture, context, and spiritual practices of the community(ies) served. The tool is now being used nationally and has become an important resource for measuring practice-based evidence and community-defined evidence in the implementation of GONA for Indigenous communities.

American Indian and Alaska Native (AI/AN) youth use alcohol and drugs at a higher rate with earlier onset than the overall youth population in the United States. Youth interventions are needed to support the prevention and reduction of substance misuse-related issues. Connecting AI/AN children to their heritage through culturally grounded prevention programs has been shown to be more effective than programs designed for the general population. The objective of this formative evaluation was to provide community-informed updates for an existing culturally grounded substance use prevention program, The Beauty Way. This study was conducted in partnership with an AI/AN-serving community organization using key informant interviews and talking circles with community members and parents. Participants revealed the challenges and obstacles AI/AN youth face, the impact of cultural values, and activities which engage youth to prevent problematic substance use. Recommendations include the importance of 1) incorporating current challenges to behavioral health such as social media and vaping, 2) including cultural values and activities including land-based learning, and 3) creating a robust facilitator guide and hiring culturally sensitive program staff. These results generated recommendations to strengthen the cultural focus and application of The Beauty Way for AI/AN youth.

This study aimed to determine the prevalence of breastfeeding initiation and continuation at two months postpartum in American Indian (AI) mothers in South Dakota and to identify factors associated with breastfeeding. Using logistic regression, data from the South Dakota Pregnancy Risk Assessment Monitoring System were used to investigate the relationship between binary breastfeeding initiation and continuation outcomes and maternal behaviors and experiences including access to health care, safe sleep practices, ability to handle life events, depression, and sources of breastfeeding information. Higher odds of initiation were seen for factors including access to health care services, ability to handle life events, and sources of breastfeeding information, while lower odds were seen for factors including safe sleep. Higher odds of continuation were seen among mothers who reported not taking long to get over setbacks and among mothers who reported no postpartum depression, while lower odds of continuation were seen among mothers practicing safe sleep. Several modifiable factors were identified as reasons for stopping breastfeeding. This information about factors associated with higher odds of breastfeeding initiation and continuation at two months postpartum can be used to inform interventions, programs, and policies designed to support breastfeeding among AI women and to guide future research in this area.

The primary purpose of this study was to 1) explore the relationship among the following variables: thoughts and feelings associated with historical loss, levels of acculturation, alcohol expectancies, and alcohol use among American Indian and Alaska Native (AI/AN) people, as well as to 2) explore predictive relationships among historical loss thoughts and feelings, alcohol expectancies, and alcohol use for AI/AN people within this sample. A convenience (community, non-clinical) sample of 188 AI/AN people completed an online survey, including questions related to alcohol use, alcohol expectancies, thoughts and feelings of historical loss, and acculturation experiences. Results indicated that gender and feelings of historical loss were the significant individual predictors of alcohol use and alcohol expectancies in a sample of AI/AN people. In addition, specific types of alcohol expectancies, when considered together, explained 24% of the variance in alcohol use experiences. Gender differences were noted in that AI/AN men were more likely than AI/AN women to engage in hazardous drinking and expected more feelings of social and physical pleasure as well as power and aggression as a result of drinking alcohol. Areas for further research were highlighted, with an emphasis on further research exploring the correlates and predictors of alcohol use and alcohol expectancies for community, non-clinical samples of AI/AN people, to further understand alcohol use motivation among AI/AN people.

While ethnic racial identity (ERI) development is associated with a variety of psychological well-being outcomes, the mechanisms through which this association operates is yet to be fully explained. During adolescence, social belonging is a developmentally salient process that can play a key role in how ERI impacts well-being. We sought to explore the mediating role of belonging to peer networks in the association between ERI and self-esteem among Native American adolescents. In this cross-sectional, mediational study, we used survey data from 317 Native American students attending a reservation high school (46.9% female; M age =16). Students' levels of ERI development were measured by combining items from two scales pertaining to ethnic identity development and racial identity. We employed a structural equation modeling approach to explore the mediating role of peer belonging in the association between ERI and self-esteem. Results suggest that our 4-item index of peer belonging was an acceptable measure of this construct. Further, the significant indirect effect of peer belonging explains a notable portion (β=.22, p ≤ .05) of the total effects of ERI on self- esteem (β=.54, p ≤ .05). This finding suggests that higher levels of ERI achievement contribute to higher levels of peer belongingness, which in turn lead to improved self-esteem among students. Implications for research and practice are discussed.

American Indian and Alaska Native (AI/AN) adolescents face health disparities resulting from historical traumas. There is a paucity of research focusing on mental health in AI/AN adolescents or the relationship between cultural connection and health. This project assesses the relationship between cultural identity and markers of mental health and well-being for AI/AN adolescents. Adolescents 12 to 18 years old from the Lumbee Tribe of North Carolina participated in this mixed-methods study. Phase 1, discussed in this manuscript, involved surveys using validated instruments to assess cultural connection and markers of mental health and well-being. Characteristics of the 122 AI/AN youth who completed the survey included: mean age 14.9 years (SD = 2.0); 61% (n = 75) assigned female at birth; 56% (n = 70) identified as female; and 4.1% (n = 5) identified as non-binary. Mean tribal affiliation (TA) and ethnic identity (EI) scores suggest strong cultural connection (TA: M = 3.1/5, SD = 0.6; EI: M = 3.4/5, SD = 0.9). Sleep quality (M = 2.63/5) and positive stress management (M = 2.06/5) were low. Bivariate and logistic regression demonstrated moderate positive correlations between EI and friendship, EI and emotional support, TA and friendship, and TA and emotional support. AI/AN adolescents in this sample have a moderate-strong connection with Native culture, marked by ethnic identity and tribal affiliation, and positive markers of mental health and well-being. Data from this study may be used for policy formulation to promote increased funding and programming addressing mental health for AI/AN youth.