Intertribal Talking Circle for the prevention of alcohol and drug use among Native American youth.

The purpose of this study was to examine the impact of a culturally based intervention, the Intertribal Talking Circle program, compared to a standard alcohol and drug abuse education, the Be A Winner program. Community-based participatory research was used to implement a two-condition, quasi-experimental study. The sample included 540 Native American youth ages 10-12 years old from three tribal areas in the United States. Data were collected at baseline, 6 and 12-months post-intervention for both the intervention and control groups using demographic, cultural identity, alcohol use, and drug use questionnaires. Regression models evaluated participants' improvement in decreasing alcohol and drug use and increasing cultural identity. Findings revealed that alcohol and drug use decreased more significantly among youth who participated in the Intertribal Talking Circle (ITC) intervention program than youth who participated in a standard alcohol and drug abuse education Be A Winner (BAW) program. Cultural identity also increased more significantly among participants who completed the Talking Circle intervention program. Native American youth ages 10-12 years old respond positively to a culturally based intervention for the reduction of alcohol and drug use. The findings highlight the importance of cultural values and identity and their significance in preventing and reducing alcohol and drug use among Native American youth.

Psychological capital variables as protective factors in indigenous youth experiencing homelessness.

Indigenous youth in the United States are at high-risk for experiencing homelessness related to adverse childhood experiences such as parental substance use and low educational attainment. Such experiences may lead to adverse physical and mental health issues; these youth also have positive attributes of psychological capita (hope, self-efficacy, resilience, optimism) that are related to health outcomes. The purpose of this secondary analysis was to describe demographic attributes and psychological capital in Indigenous youth experiencing homelessness (IYEH) who participated in a longitudinal intervention study related to safe sex behaviors and life satisfaction. From a total of 602, Indigenous participants (n = 111; mean age 21.25 ± 1.82 years) were recruited from drop-in centers in Austin, Texas and Columbus, Ohio. Data were collected immediately after the intervention and at 3- and 6-month intervals. For this analysis, only data collected at the final time-point were used. Valid scales with Cronbach alphas of 0.75-0.92 (Hope, Resilience, Optimism, Self-efficacy for Substance Refusal, Self-efficacy for Safer Sex, Safe Sex Behaviors, Social Connectedness, and Life Satisfaction) were used. The majority of the IYEH reported smoking, drinking, and using drugs. Psychological capital variables of hope, self-efficacy for negotiating safer sex, resilience, and optimism were significantly related to one another, but not to safe sex behaviors or intention to use condoms. Resilience and optimism were significantly related to social connectedness but not to other psychological capital variables. Life satisfaction was significantly associated with hope, resilience, and optimism. Findings have implications for further theory and research development.

Sustainability of an intervention for the prevention of substance use within Native American communities.

The outcomes of this study revealed the importance of recruiting local Native American tribal community members as participants in an Adult Facilitator Trainee Program for a cultural based intervention, Intertribal Talking Circle (ITC), that addresses prevention of substance use among Native American youth. Survey results indicate that Native-Reliance (cultural identity) and self-efficacy increased among the trainees from base-line to 3-months post the training session. Themes emerged from qualitative interviews conducted with the participants that described their readiness to implement and sustain the Talking Circle intervention program within their tribal communities after the research project was completed.

A commercial tobacco and alcohol use intervention for urban Native American youth.

OBJECTIVE: Westernized alcohol and commercial tobacco use prevention approaches for Native Americans have not been effective, or sustainable. The overall objective of this study examined the effect of the culturally based Urban Talking Circle (UTC) intervention versus standard education (SE) program for the prevention of alcohol and commercial tobacco use among urban Native American youth. DESIGN: The study employed a 2-condition quasi-experimental design and utilized convenience and snowball sampling methods for recruiting 100 urban Native American youth participants in two urban Native American community program locations in Florida. Study participants were randomized by their urban Native American community program location to one of the 2-conditions. These included the standard education (SE) program used within United States school systems (drug abuse resistance education) and the Urban Talking Circle (UTC) intervention, culturally tailored and developed for urban Native American youth from the culturally based Talking Circle Intervention for rural Native American Youth. The Native American Alcohol Measure for Youth (NAAMY) and Native Reliance Questionnaire were utilized to collect participants' data. Participants' data was analyzed using multivariate analysis of variance to determine differences between the scores on all measures at pre/post-intervention for the 2-conditions. RESULTS: Study findings indicate that a culturally based intervention was more effective for the reduction of commercial tobacco and alcohol use than a non-culturally based intervention for urban Native American youth. CONCLUSION: The study findings emphasized that the utilization of the culturally tailored UTC intervention reduced involvement associated with alcohol and commercial tobacco use.

A Cultural-Based approach to address substance use among urban Native American young adults.

Native American young adults residing in urban communities are particularly vulnerable to substance use. After leaving high school, the pressures and stress of continuing education, finding employment, and the responsibilities related to family and tribal community obligations predispose these young adults to substance use. This study used a pre/post test design to evaluate a cultural-based Talking Circle intervention for the prevention of substance use among urban Native American young adults, ages 18-24. Three measures were used that included the Native-Reliance Questionnaire, the Indigenous-Global Assessment of Individual Needs (I-GAIN) Substance Use Scale, and the Patient Health Questionnaire (PHQ-9) measure for severity of depression. Findings revealed that participants demonstrated a higher sense of Native-Reliance, decrease in substance use, and a decrease in the PHQ-9 depressions scores from baseline to 6-month postintervention. These findings validate the importance of cultural-based interventions for the prevention of substance use among urban Native American young adults.

Formative Research and Cultural Tailoring of a Substance Abuse Prevention Program for American Indian Youth: Findings From the Intertribal Talking Circle Intervention.

Background. Substance use among American Indians (AIs) is a critical health issue and accounts for many health problems such as chronic liver disease, cirrhosis, behavioral health conditions, homicide, suicide, and motor vehicle accidents. In 2013, the highest rates of substance use and dependence were seen among AIs when compared to all other population groups, although these rates vary across different tribes. Among AI adolescents, high rates of substance use have been associated with environmental and historical factors, including poverty, historical trauma, bicultural stress, and changing tribal/familial roles. Our project, the Intertribal Talking Circle intervention, involved adapting, tailoring, implementing, and evaluating an existing intervention for AI youth of three tribal communities in the United States. Formative Results. Community partnership committees (CPCs) identified alcohol, marijuana, and prescription medications as high priority substances. CPC concerns focused on the increasing substance use in their communities and the corresponding negative impacts on families, stating a lack of coping skills, positive role models, and hope for the future as concerns for youth. Cultural Tailoring Process Results. Each site formed a CPC that culturally tailored the intervention for their tribal community. This included translating Keetoowah-Cherokee language, cultural practices, and symbolism into the local tribal customs for relevance. The CPCs were essential for incorporating local context and perceived concerns around AI adolescent substance use. These results may be helpful to other tribal communities developing/implementing substance use prevention interventions for AI youth. It is critical that Indigenous cultures and local context be factored into such programs.

A Culture-Based Talking Circle Intervention for Native American Youth at Risk for Obesity.

This community-based study explored the effectiveness of an after-school cultural-based intervention for Native American youth at risk for obesity. A standard health education after-school program served as the comparison control condition. Cherokee self-reliance (cultural identity), perceived stress, and obesity knowledge and related behaviors were the three outcome measures evaluated at baseline and immediate post-intervention. Findings revealed that participants who completed the cultural-based intervention had better results on the three outcome measures in comparison to the standard health education program.

A Rural Native American Community Experiences Related to Emotional and Mental Health Well-Being during the COVID19 Pandemic.

Purpose: This qualitative study was conducted as part of a larger nationwide study, the Aegis Project that investigated the impact of the COVID19 pandemic, infection and reinfection, and the potential long-term immunity to SARS-CoV-2 and will be reported in a future paper. The study is a collaborative effort among The University of Texas at Austin School of Nursing, Indiana University at Bloomington School of Public Health, and a rural-based Tribe located in the Midwest. The qualitative component of the study explored the experiences that impacted the emotional and mental health well-being during the COVID19 pandemic. Methods: Data were collected using open-ended interview questions regarding participants' experiences during the pandemic. Results were analyzed using the Consensual Qualitative Research (CQR) method which includes the process of categorizing data into specific themes by means of the research team's discourse, external auditing, and agreement. Results: Four themes emerged related to emotional and mental health well-being experiences that include: 1) loss of connectedness, 2) increase in stress, 3) increase in anxiety, and 4) learning to cope. Conclusions: Understanding the lived experiences of Native Americans during the COVID19 pandemic is needed to help guide the development and testing of culturally based interventions to improve the emotional and mental health well-being of Native American communities during pandemics or other distressful incidences such as natural disasters.

The health challenge of stress experienced by Native American adolescents.

Little is known about how Native American youth experience or manage stress. The purpose of this study was to describe the health challenge of stress experienced by Cherokee-Keetoowah adolescents and to identify approaches used to manage stress. All adolescents regardless of ethnicity face normative sources of stress, such as daily hassles and transition experiences like moving to a new school. Native American youth are known to have significantly greater stress, related to social and economic factors, than their white peers. They are exposed to a variety of continuous stressors including poverty and family disruption. A qualitative story-theory-guided approach was used to conduct a secondary analysis of existing data collected from a larger study where written stories of stress were gathered from 50 Cherokee-Keetoowah adolescents ranging in ages from 14 to 18 years. The data analysis was guided by the story inquiry method to identify dimensions of the health challenge of stress and approaches used to resolve the health challenge. Three health challenge groups were identified: burden of expectations, relationship disruption, and imposing feelings and the actions of others. The most frequently described stories of stress expressed were the burden of expectation of self or from others (n=33). Connecting with valued others, engaging in meaningful activities, and choosing a positive attitude about change were themes that characterized ways that these adolescents managed stress. It is essential to understand how Native American adolescents experience stress and what they do to manage it if we wish to deter the physical and mental consequences of stress. The development of stress-reducing culturally competent interventions that are built on a foundation such as story sharing is a culturally congruent approach for intervening with Native American adolescents.

Native American adolescent narrative written stories of stress.

OBJECTIVE(S): The purpose of this paper is to report study findings related to themes of stress and coping strategies experienced by non-reservation-based Native American adolescents as expressed by their written stories. DESIGN: A qualitative descriptive narrative approach was used to capture written stories of stress. ANALYSIS: Key concepts and themes were identified by using the consensual qualitative research (CQR) approach from the participant's stories of stress. RESULTS: Written stories of stress were collected and analyzed from a convenience sample of 179 Native American adolescent's ages 13-18-years old. Five major themes related to experiences of stress emerged from the stories including (a) relationships, (b) responsibilities, (c) socioeconomic status, (d) negative coping strategies, and (e) positive coping through Native-Reliance. CONCLUSION: The findings reveal the importance of understanding the types and response to stress experienced by Native American adolescents.