HPV knowledge, attitudes, and beliefs among Northern Plains American Indian adolescents, parents, young adults, and health professionals.

Native American women in the Northern Plains have a high prevalence of human papillomavirus (HPV) and high incidence of cervical disease and cervical cancer. HPV vaccination coverage is shown to be lower among nonwhite populations and disparity populations. We assessed HPV knowledge, attitudes, and beliefs towards HPV and HPV vaccination during a community-based participatory research project among tribal youth, young adults, parents, and health professionals. In 2009, we recruited a total of 73 individuals to participate in four tribal focus groups: tribal health providers, (n=10), Indian Health Service providers (n=7), young adult women ages 19-26 (n=22), girls (14-18) (n=18), and parents (n=16). Of these, 62 (84.93 %) completed a survey, which included 10 healthcare providers, 22 young adults, 14 teens, and 16 parents. We employed a qualitative thematic analysis of focus group transcript data and conducted frequency analysis of survey data, which were both reviewed and triangulated by a Community Advisory Board. Based on the results of this study, the tribal community advisory board identified local tribal settings for interventions to increase HPV vaccination coverage through health education classes and a school-based vaccination clinic. In addition to tribal community-wide education events to increase awareness of HPV disease, the HPV vaccine, provider-specific training was identified as a potential intervention. These community-based focus group findings underscore the importance of locally and cultural tailored educational interventions to further increase HPV knowledge and HPV vaccination among disparate populations like American Indian adolescent and young adult women.

The end of the Kachemak tradition on the Kenai Peninsula, southcentral Alaska.

The Kachemak tradition was established by ca. 3000 B.P. in Kachemak Bay. Probably somewhat later a variant termed Riverine Kachemak, with a population adapted to salmon and terrestrial resources, appeared on the northern Kenai Peninsula. The Kachemak tradition people seem to have abandoned Kachemak Bay by ca. 1400 B.P. Seven of 12 available Kachemak tradition dates predate 1400 B.P. even at two sigma. Scattered younger dates are thus suspect outliers. The end of Riverine Kachemak tradition has been placed at ca. 1000 B.P., at which time the population was supposedly replaced by in-migrating groups ancestral to the Dena'ina Athapaskans. Close examination of the numerous available radiocarbon dates shows that most Riverine Kachemak dates cluster in the early centuries of the First Millennium A.D. and most Dena'ina dates substantially postdate 1000 A.D. Probably the Riverine Kachemak and Dena'ina peoples never met on the Kenai River. However, the correspondence in date ranges between Kachemak Bay and Riverine Kachemak is striking, suggesting their fates were linked. Both traditions collapsed by 1400-1500 B.P. The causes are probably multiple but do not include cultural replacement.