Indigenous Knowledge: Revitalizing Everlasting Relationships between Alaska Natives and Sled Dogs to Promote Holistic Wellbeing.

INTRODUCTION: Indigenous peoples have documented their culture's history in oral stories, revealing lessons about holistic relationships fostering perseverance. Despite vast differences in time, relationships and stories are equally important today. Athabascans retain their values, life skills, and wellness through cultural practices. Creating opportunities for youths to learn through reciprocal relationships increases wellness in Indigenous communities, highlighting the significance of community-developed programs that connect youths to their place and culture. METHOD: Athabascan youths in rural Alaska get hands-on experience and Elder mentorship working with sled dogs in the Frank Attla Youth and Sled Dog Care-Mushing Program (FAYSDP). Through a community-based participatory research partnership with the community of Huslia and Jimmy Huntington School, we examined how FAYSDP affects youths, and how relationships within culture and land promote wellbeing. Fifteen middle and high-school youths shared their perspectives on how FAYSDP impacts them and their community using photovoice and digital storytelling. Nineteen adults contributed their perspectives in focus groups. We used emerging themes (inductive) and Athabascan cultural values and elements of social capital (deductive approaches) to analyze the qualitative data. RESULTS: Findings illustrate how FAYSDP promotes wellbeing by empowering youths to apply what they learn to generate their own knowledge, while centering communities around culturally significant practices such as dog mushing. It connects youths to their home and their cultural values, using dogs as the driving force to bridge generations and foster youth wellness. DISCUSSION: We discuss implications for community-based programs that engage Elders as teachers and the land as their classroom to promote youth holistic wellness.

Cultural values, coping, and hope in Yup'ik communities facing rapid cultural change.

Historical trauma and rapid cultural change contribute to a high burden of stress in Alaska Native communities. The goal of the Yup'ik Experiences of Stress and Coping Project was to better understand stress and coping in Yup'ik communities and the role of cultural values and practices in coping. Sixty Yup'ik adults aged 18-84 years took part in semistructured interviews. They discussed how they coped with salient stressful experiences and shared the things that bought them hope and peace. Interview themes were identified and inter-relationships between themes were explored through social network analysis. Participants discussed the importance of cultural traditions in coping, including subsistence, dancing and drumming, intergenerational transmission of knowledge, and reflective awareness of interconnections with others. Participants found strength in family relationships, spirituality, helping others, and coming together as a community. Three coping clusters emerged: Ilaliurucaraq (be welcoming) involved opening one's frame of mind and building connections; Yuuyaraq (Yup'ik way of life) focused on Yup'ik traditions and values; and Assircaarturluni Yuuyaraq (try to live a better life) involved healing from historical trauma. Findings illustrate the resilience and evolving strengths of rural Yup'ik communities facing a continually changing cultural landscape and provide information for developing community-driven culturally based interventions.

The efficacy of an integrated risk reduction intervention for HIV-positive women with child sexual abuse histories.

Child sexual abuse (CSA) is associated with HIV risk behaviors [Bensley, L., Van Eenwyk, J., and Simmons, K. W., 2003.] and more prevalent among women living with HIV than in the general population [Koenig, L. J., and Clark, H., 2004]. This randomized Phase~I clinical trial tested the impact of a culturally congruent psychoeducational intervention designed to reduce sexual risks and increase HIV medication adherence for HIV-positive women with CSA histories. An ethnically diverse sample of 147 women were randomized to two conditions: an 11-session Enhanced Sexual Health Intervention (ESHI) or an attention control. Results based on "intent to treat'' analyses of pre-post changes are reported here. Additional analyses explored whether the observed effects might depend on "intervention dose,'' i.e., number of sessions attended. Women in the ESHI condition reported greater sexual risk reduction than women in the control condition. Although there were no differences between women in the ESHI and control groups on medication adherence, women in the ESHI condition who attended 8 or more sessions reported greater medication adherence at posttest than control women. The findings provide initial support for this culturally and gender-congruent psychoeducational intervention for HIV-positive women with CSA, and highlight the importance of addressing the effects of CSA on sexual risk reduction and medication adherence in preventive interventions for women.