American Indian and Alaska Native Mental Health Research最新文献

Historical trauma has been associated with many health and social issues. However, there is little understanding of how American Indian (AI) youth cope with historical trauma. Sense of Coherence (SOC) provides a promising framework for studying the relationship between resiliency and historical trauma, as it is a theorized mechanism that helps individuals cope with ongoing stress. A multi-method study examining the potential relationship between SOC and historical trauma revealed that higher levels of SOC predicted fewer historical trauma-related symptoms and provided rich detail about how an AI youth sample conceptualized stress and coping. Implications and future directions are discussed.

American Indians and Alaska Natives (AI/ANs) have the highest smoking prevalence, smoking-related disease, and mortality rates of any racial or ethnic group. Three AI health clinics in Minnesota implemented an evidence-based tobacco dependence treatment intervention that included provider education and customized clinical system tools. A baseline assessment of each clinic facility guided the focus of the intervention and tailored the clinical system tools. Clinic staff were assessed with pre/post-training evaluations and annual assessments. Results indicated self-reported improvements in the rate of identifying smoking status (57% to 89%), documenting smoking status (from 60% to 80%), and providing evidence-based treatments such as pharmacotherapy (from 36% to 78%).

The Psychological Sense of School Membership (PSSM) scale is widely used to measure school belongingness among adolescents. However, previous studies identify inconsistencies in factor structures across different populations. The factor structure of the PSSM has yet to be examined with American Indian/Alaska Native (AI/AN) youth, a population of keen interest given reports of their educational and health disparities, and the potential of belongingness as a protective factor against risk behaviors. Thus, this study examined the factor structure of the PSSM in two samples of AI adolescents (N = 349). The two main aims of this study were to 1) determine if a comparable factor structure exists between the two AI groups and 2) examine the factor structure of the PSSM for use in AI/AN populations. Randomization analysis was used to test research aim one, and exploratory factor analysis was used to test research aim two. Analyses revealed that comparable factor structures existed based on responses from the two AI groups. Analyses also identified two factors: school identification/peer support and connection with teachers. Moreover, negatively worded statements were found to be unreliable and were removed from the final scale, reducing the PSSM to 13 items. Findings from this study will assist researchers and clinicians with assessing sense of school belongingness in AI/AN adolescents and with appropriately interpreting aspects of belongingness for this population.

Binge drinking appears to be a risk factor, facilitator, and method of suicidal and non-suicidal self-injury for some American Indian (AI) youth. We examined characteristics, patterns, and motivations for binge use among AI adolescents (N = 69; 10-19 years-old) who recently engaged in binge drinking. The majority used alcohol alone (53.7%) or a combination of alcohol and marijuana (31.3%) for their binge event. Gender differences emerged with boys more severely affected than girls. Forty-seven percent reported lifetime suicidal thoughts. This study represents one of the first in-depth examinations of substance use and related behaviors among AI adolescents who have engaged in recent binge use.

Cardiovascular disease is the number one cause of death among American Indians and Alaska Natives (AI/AN). Utilizing narratives from members of a Pacific Northwest tribe, this paper explores perceptions about behaviors affecting cardiovascular health through tribal members' lived experiences related to place-based environmental historical trauma. Findings from narrative analysis indicate that ambivalence is an effect of historical trauma and complicates the adoption of protective cardiovascular health behaviors. Tribal narratives indicate a path to overcome this ambivalence stemming from historical environmental trauma through revitalization, adaptation, and re-integration of traditional cultural practices to contemporary contexts. By creating their own health promotion response, one that is not imposed or colonizing, tribal members are re-generating cultural practices and health behaviors associated with lowered risks of cardiovascular disease.

Measuring mental health accurately is an important endeavor for screening purposes. Depression scales, such as the Center for Epidemiologic Studies Depression (CES-D) scale, have been well-established among different populations. Yet, little work has been done to examine the reliability and validity of the CES-D among older American Indians and Alaska Natives. The purpose of our study was to examine the factor structure, reliability, and concurrent validity of the full 20-item and abbreviated 12-item CES-D scale with a sample of older American Indians. Our findings demonstrate excellent internal reliability and concurrent validity of the full and abbreviated CES-D scales in our study sample.

BASC-2 SRP-A scores of 162 American Indian (AI) youth were compared with those of an ethnically diverse sample (N = 200) to explore group equivalence. A MANOVA indicated group differences among the five composites. AIs outscored non-Natives in Inattention/Hyperactivity. We examined AIs' ADHD scores in relation to their acculturation strategies, measured using the Bicultural Ethnic Identity Scale. Culturally marginalized AIs (low White and low Indian acculturation) reported stronger ADHD symptoms than bicultural, assimilated, or separated youth. The potential impact of culture on clinical measures is discussed.

The objective of the present study was to assess whether selfreported physical activity barriers could be reduced among American Indian elders who participated in a 6-week randomized physical activity trial that compared the use of a pedometer only to that of pedometers with step-count goal setting. Elders (N = 32) were compared on the Barriers to Being Physically Active Quiz after participating in a pilot physical activity trial. Elders were classified into high- and low-barrier groups at baseline and compared on self-reported physical activity, health-related quality of life, pedometer step counts, and 6-minute walk performance. At the conclusion of the 6-week trial, only the lack of willpower subscale significantly decreased. The low-barrier group reported significantly higher physical activity engagement and improved mental health quality of life than the high-barrier group. The groups did not differ on daily step counts or 6-minute walk performance. Additional research is needed with a larger sample to understand relevant activity barriers in this population and assess whether they can be modified through participation in structured physical activity and exercise programs.