American Indian and Alaska Native Mental Health Research最新文献

This study examined the usefulness of a survey on underage drinking in a rural American Indian community health clinic. One hundred ninety-seven youth (90 male, 107 female; age range 8-20 years) were recruited from clinic waiting rooms and through community outreach. The study revealed that the usefulness of the survey was twofold: Survey results could be used by clinic staff to screen for underage drinking and associated problems in youth served by the clinic, and the process of organizing, evaluating, and implementing the survey results accomplished several important goals of community-based participatory research.

Rural American Indian (AI) middle school students with depressive symptoms who participated in a culturally modified version of the Adolescent Coping with Depression (CWD-A) course (n = 8) reported significant improvement in depressive symptoms at post-intervention and at 3-month follow-up. There was also a nonsignificant but clinically relevant decrease in participants' anxiety symptoms. Students reported satisfaction with the intervention, and it was potentially more cost-effective and less stigmatizing than the individualized treatment-as-usual interventions to which it was compared. These results suggest the CWD-A is a promising approach for reducing depressive and anxiety symptoms in rural AI students and should be further evaluated with a larger sample of students.

In this study we investigated the mental health treatment preferences held by Alaska Native (AN) college students regarding treatment type, treatment provider, and therapy roles. Preferences were compared between AN and Caucasian participants and also between ANs with high and low identification with their Indigenous culture. While there were many similarities between groups, some important differences were found. The results of this study have significant implications for making mental health treatments more available and culturally appropriate for ANs.

Health disparities in fetal alcohol spectrum disorders (FASD) are of high importance to American Indian/Alaska Native (AI/AN) communities. We conducted focus groups and interviews with 21 AI/AN women and key informants in Southern California to modify a brief, Web-based program for screening and prevention of prenatal alcohol use. This process resulted in several important program modifications and was essential for fostering partnerships between researchers and the community, engaging community members in research, and identifying community priorities.

Discounting occurs when the value of an outcome changes because its delivery is delayed or uncertain. Discounting provides insight into how individuals make decisions, with rates of discounting being related to a number of behavioral disorders. In this study, 39 American Indians (AIs), 29 female, were recruited from the psychology department participant pool at a university in the Northern Plains to complete an acculturation inventory and delay- and probability-discounting tasks related to money, health care, and education reform. Results from ANOVAs showed that participants did not differentially discount the delayed outcomes, but discounted the probabilistic monetary outcomes to a greater extent than probabilistic outcomes involving education reform, suggesting that participants were more risk averse with the monetary, than the education, outcomes. Differences in discounting were not observed as a function of whether the outcome would occur on or off a tribal reservation. Results from regression analyses showed that participants' affiliation with the majority culture was also related to how they discounted probabilistic monetary outcomes. The present study represents the first attempt to measure probability discounting in AI participants and is the first to show differences in this type of decision making. The results, therefore, represent a step forward in understanding when risk-averse versus risk-prone decisions (i.e., a small but certain outcome vs. a better but uncertain outcome) may be made, and how those decisions are related to acculturation in AIs.

Computer-assisted interviewing techniques have increasingly been used in program and research settings to improve data collection quality and efficiency. Little is known, however, regarding the use of such techniques with American Indian (AI) adolescents in collecting sensitive information. This brief compares the consistency of AI adolescent mothers' reporting of sensitive sexual and drug use behaviors gathered through three distinct interviewing techniques: computer-assisted (ACASI), self-administered questionnaire (SAQ), and face-to-face interview (FTFI). Endorsement of drug use and reporting of sexual activity was highest for ACASI, followed by SAQ, and was significantly lower for FTFI. Relatively strong agreement was measured between ACASI and SAQ, and relatively poor agreement was measured between the ACASI and FTFI. Findings support the use of computer-assisted interviewing techniques with AI adolescents, and implications for future research are discussed.

In a cross-sectional study, we examined the role of explanatory styles and negative life events in the depressive experiences of AI youth. Ninetythree AI youth (49% female, ages 11-14 years) completed surveys assessing for explanatory style, negative life events, and depressive symptoms. Path analyses indicated that both the occurrence of negative life events within the past 6 months and a pessimistic explanatory style predicted more depressive symptoms. However, a moderation path model provided a superior fit to the data, indicating that the occurrence of negative life events was more strongly associated with depressive symptoms for those AI youth with a more pessimistic explanatory style. Findings are discussed in terms of potential interventions that can promote the well-being of this understudied and underserved population.

This article examines changes in the drug resistance strategies used by urban American Indian (UAI) middle school students during a pilot test of a substance use prevention curriculum designed specifically for UAI youth, Living in 2 Worlds (L2W). L2W teaches four drug resistance strategies (refuse, explain, avoid, leave [R-E-A-L]) in culturally appropriate ways. Data come from 57 UAI students (53% female; mean age = 12.5 years) who participated in L2W during an academic enrichment class for Native youth at two Phoenix schools. Students completed a pre-test questionnaire before the L2W lessons and a post-test 7 months later. Questions assessed the use of R-E-A-L and alternative strategies commonly reported by UAI youth (change the subject, use humor). Tests of mean differences from pre-test to post-test showed significant increases in use of refuse, explain, and leave, and an expanding R-E-A-L repertoire. Use of more passive strategies (avoid, use humor) did not change significantly, except for change the subject, which increased. Changes in the use of strategies did not differ significantly by gender, age, school grades, parental education, or length of urban residence. The L2W curriculum appears effective in teaching culturally relevant communication strategies that expand UAI youths' repertoire of drug resistance skills.

Media technologies, including the Internet, cell phones, and video games, offer new avenues to reach Native youth on sensitive health topics. Project Red Talon, a sexually transmitted disease (STD)/HIV prevention project that serves the 43 federally recognized tribes in Oregon, Washington, and Idaho, used community-based participatory research methods in partnership with the Northwest tribes to review existing technology-based interventions and generate recommendations for designing interventions that reflect the culture, needs, and organizational capacities of participating tribes and Native youth. These findings are now being used to guide the development of technology-based health interventions targeting American Indian/Alaska Native teens and young adults.

This article provides an example of a culturally responsive, community-based project for addressing social determinants of health in rural American Indian (AI) communities through: 1) empowering youth and community voices to set directions for HIV, sexually transmitted infections, and unintended pregnancy prevention and education efforts; 2) using Photovoice to promote healthy relationships among AI youth; 3) using the socioecological model (Centers for Disease Control and Prevention, 2004; 2011) as a framework for organizing the creation and subsequent sharing of Photovoice messages from individual empowerment, to relationships, communities, institutions, and general society; and 4) framing analysis of Photovoice projects in alignment with Bell's (2010) model of storytelling for social justice that connects narrative and the arts in anti-racist teaching. A discussion on future steps and recommendations for future research is provided.