Acceptability and feasibility of an intervention for Alaska Native and American Indian couples.

Objective: This acceptability and feasibility study assessed a previously tested movie discussion intervention culturally adapted for a tribal health setting. Background: Despite family and relationships being important in Alaska Native and American Indian (ANAI) cultures, social health interventions supporting committed ANAI couples have not been investigated. Couples watching and discussing movies can promote and sustain relationship health as effectively as intensive skill-building classes. Method: This study culturally adapted a movie discussion intervention. Multiple stakeholders guided adaptations, including changes to intervention duration, recommended movies, discussion guide, and study measures. Eligible participants were cohabitating adults in a committed relationship, with at least one person in the couple being ANAI. Participants watched and discussed movies over 4 weeks at home or in person. Study measures assessed demographics, relationship characteristics, and intervention acceptability and feasibility. Results: Twenty-three couples participated: 87% chose at-home participation, 70% completed the intervention. Almost 90% of couples felt comfortable discussing the movies, felt the discussion guide improved communication, and would recommend the intervention to other couples, but 26% were mildly stressed by the discussions. Conclusion: This intervention was a feasible and acceptable way to help ANAI couples maintain positive relationship features. Implications: This intervention could support ANAI couples in regions with limited access to behavioral health services.

Health care utilisation changes among Alaska Native adults after participation in an indigenous community programme to address adverse life experiences: a propensity score-matched analysis.

The aim of this study was to investigate whether participation in Family Wellness Warriors Initiative (FWWI), an Alaska Native program that addresses adverse life experiences, is associated with changes in health care utilisation. The study method was a propensity score-matched cohort analysis using retrospective electronic health record data from Southcentral Foundation, a tribal health care system, from 2012 to 2017. Ninety p\articipants in FWWI trainings were identified as the intervention cohort and were propensity matched with 90 people who participated in other emotional wellness-related interventions. The primary outcome was the number of total health system visits. Secondary outcomes included emergency department (ED) visits, substance-use visits and visits with somatisation potential. After adjustment for covariates, FWWI participants showed a 36% reduction in total system visits (incidence rate ratio 0.64, 95% CI 0.49-0.84) and a 70% reduction in substance use visits (incidence rate ratio 0.30, 95% CI 0.10-0.93) when compared to the control. FWWI participants showed a 40% reduction in ED visits (incidence rate ratio 0.60, 95%CI 0.35-1.02) when compared to the control that was borderline significant. No significant differences were found for visits with somatisation potential (incidence rate ratio 1.25, 95% CI 0.79-1.99).

Family Wellness Warriors.

This article discusses the development and implementation of a culturally relevant resiliency model to address the physical, mental, emotional, and spiritual wellness needs of adults who have experienced harm. Common diseases in adulthood have been linked to abuse in childhood. To end abuse and improve health in Alaska, Alaska Native people are forming partnerships with health care organizations, government agencies, social service providers, and faith communities to disseminate Family Wellness Warriors Initiative strategies. Nearly 3000 people have participated in Family Wellness Warriors Initiative trainings. Through this healing work, families and communities are working together to change health disparities and restore hope.