ABSTRACT
BACKGROUND: Depression among older adults is a pressing public health concern, necessitating accurate assessment tools. The Geriatric Depression Scale (GDS) offers a brief and efficient means of screening depressive symptoms, yet its performance across ethno-racial groups remains understudied. This study aimed to compare the ability of various brief forms of the GDS to detect depressive symptoms and to assess potential ethno-racial differences in symptom endorsement among White, Black/African-American, and American Indian/Alaska Native older adults. METHODS: Data were obtained from the Wisconsin Alzheimer's Disease Research Center (ADRC) clinical cohort, comprising 555 cognitively healthy individuals at risk for dementia. We used participants' baseline data for this cross-sectional analysis. Depressive symptoms were assessed using multiple brief forms of the GDS, derived from a systematic review and meta-analysis. We examined internal consistency and correlations with global Clinical Dementia Rating (CDR) scores. We conducted Kruskal-Wallis tests and post hoc pairwise comparisons to assess ethno-racial group differences in symptom endorsement. RESULTS: Descriptive statistics revealed a predominance of female and White participants, with notable representation from Black and American Indian/Alaska Native groups. All GDS versions demonstrated moderate to high internal consistency. Significant positive correlations were observed between GDS scores and global CDR scores. Ethno-racial group differences in depressive symptom endorsement were evident, with Black participants consistently reporting higher levels of symptoms across most GDS versions. However, American Indian/Alaska Native participants endorsed significantly fewer symptoms than Black participants in one GDS version. CONCLUSION: The study highlights the importance of considering ethno-racial differences in depressive symptomatology when assessing older adults. While the GDS demonstrates overall reliability, variations in symptom endorsement across different ethno-racial groups underscore the need for culturally sensitive assessment tools and interventions. Future research should further explore these group differences and develop tailored approaches to depression screening and treatment in diverse older adult populations.
Subject(s)
Depression , Psychiatric Status Rating Scales , Aged , Aged, 80 and over , Female , Humans , Male , Black or African American/psychology , Cross-Sectional Studies , Depression/diagnosis , Depression/ethnology , Ethnicity , Geriatric Assessment/methods , Psychiatric Status Rating Scales/standards , American Indian or Alaska Native/psychology , White/psychologyABSTRACT
Enhancing social support and connectedness can reduce suicide risk, yet few studies have examined this effect in American Indian and Alaska Native (AI/AN) adults. We assessed suicidal ideation and behavior, thwarted belongingness, social support, enculturation, historical trauma, and traumatic life events in 709 AI/AN adults at high risk of suicide from five AI/AN communities. Suicidal ideation was associated with thwarted belongingness and protected against by social support and engaging in AI/AN ceremonies. Among those who made lifetime suicide attempts, traumatic life events, symptoms of depression/anxiety due to historical trauma, and thwarted belongingness were linked to more attempts. More engagement in cultural practices was associated with fewer suicide attempts. Higher levels of social support were associated with more suicide attempts, an observation potentially attributable to the cross-sectional nature of the study. Interventions should focus on protective factors and context-specific interventions emphasizing community history, values, and strengths.
Subject(s)
American Indian or Alaska Native , Social Support , Suicidal Ideation , Suicide Prevention , Adult , Female , Humans , Male , Middle Aged , American Indian or Alaska Native/psychology , Cross-Sectional Studies , Depression/psychology , Depression/ethnology , Protective Factors , Suicide/psychology , Suicide/ethnology , Suicide, Attempted/psychology , Suicide, Attempted/ethnologyABSTRACT
Prior research suggests that culturally aligned, accessible and lower-barrier interventions are well-placed to align with the needs of American Indian and Alaska Native (AI/AN) people with alcohol use disorder (AUD). Taking into account community members' suggestions and the need for physical distancing during the COVID-19 pandemic, our team developed a protocol for virtual Harm Reduction Talking Circles (HaRTC) to incorporate these points. The aims of this 8-week, single-arm pilot were to initially document feasibility, acceptability, and outcomes associated with attendance at virtual HaRTC, which integrates the accessibility of virtual connection, a lower-barrier harm-reduction approach, and a culturally aligned intervention. Participants (N = 51) were AI/AN people with AUD (current or in remission) across 41 Tribal affiliations and 25 US states. After a baseline interview, participants were invited to attend 8, weekly virtual HaRTC sessions. At the baseline, midpoint and post-test assessments, we collected data on virtual HaRTC acceptability, cultural connectedness, quality of life, and alcohol outcomes. Of the 123 people approached, 63% were interested in and consented to participation. Participants attended an average of 2.1 (SD = 2.02) virtual HaRTC sessions, with 64% of participants attending at least one. On a scale from 1 to 10, participants rated the virtual HaRTC as highly acceptable (M = 9.3, SD = 1.9), effective (M = 8.4, SD = 2.9), culturally aligned (M = 9.2, SD = 1.5), helpful (M = 8.8, SD = 1.9), and conducted in a good way (M = 9.8, SD = 0.5). Although the single-arm study design precludes causal inferences, participants evinced statistically significant decreases in days of alcohol use and alcohol-related harm over the three timepoints. Additionally, both sense of spirituality, which is a factor of cultural connectedness, and health-related quality of life increased over time as a function of the number of HaRTC sessions attended. Virtual HaRTC shows initial feasibility and acceptability as a culturally aligned intervention for AI/AN people with AUD. Future randomized controlled trials will provide a test of the efficacy of this approach.
Subject(s)
Alcoholism , American Indian or Alaska Native , Harm Reduction , Adult , Female , Humans , Male , Middle Aged , Alcoholism/ethnology , Alcoholism/psychology , Alcoholism/prevention & control , American Indian or Alaska Native/psychology , Pilot Projects , Quality of Life , United StatesABSTRACT
BACKGROUND: Despite historical and contemporary trauma, American Indian and Alaska Native (AIAN; Indigenous) communities responded with resilience to the COVID-19 pandemic. However, AIANs experienced disproportionate rates of infection, hospitalization, death, and reduced life expectancy. School closures exacerbated disparities, leading to learning loss, economic instability, and mental health challenges among AIAN youth. METHODS: The Project SafeSchools cohort study employed a comprehensive longitudinal convergent mixed-methods approach, integrating community-based participatory research principles. The study enrolled Navajo Nation caregivers whose children were eligible to attend local reservation-based schools. We conducted an analysis of caregiver self-report baseline data collected between August 2021 and May 2022. RESULTS: A total of 242 caregivers completed at least part of the baseline assessment and were included in data analysis. Caregivers were primarily female (88.7%), non-Hispanic (97%), and Indigenous (97%). Most caregivers were in their late 30s (mean age 38), with varying educational backgrounds and employment statuses. Children were evenly split between males and females and distributed across different age groups. Most children attended school at baseline in various formats, including in-person, hybrid, and online-only settings. Caregivers reported a range of psychosocial and behavioral risks, including general mental distress, depressive symptoms, and anxiety for themselves and their children. Furthermore, caregivers and children exhibited various protective factors, such as strong cultural identity, resilience, and academic self-efficacy. CONCLUSIONS: This study highlights the higher rates of mental health distress among participating caregivers and children compared to national averages. Despite these challenges, cultural protective factors remained strong and should guide future crisis response efforts.
Subject(s)
COVID-19 , Caregivers , Mental Health , Humans , COVID-19/epidemiology , Male , Female , Caregivers/psychology , Child , Adult , Adolescent , Indians, North American/psychology , Indians, North American/statistics & numerical data , Schools , SARS-CoV-2 , American Indian or Alaska Native/psychology , American Indian or Alaska Native/statistics & numerical data , Alaska Natives/psychology , Alaska Natives/statistics & numerical data , Longitudinal Studies , Middle Aged , Sociodemographic Factors , Resilience, Psychological , Young Adult , United States/epidemiologyABSTRACT
INTRODUCTION: Severe inequities in depression and its diagnosis and treatment among rural-dwelling, racial-minority and ethnic-minority older adults compared with their urban white counterparts result in cognitive impairment, comorbidities and increased mortality, presenting a growing public health concern as the United States (US) population ages. These inequities are often attributable to social and environmental factors, including economic insecurity, histories of trauma, gaps in transportation and safety-net services, and disparities in access to policy-making processes rooted in colonialism. This constellation of factors renders racial-minority and ethnic-minority older adults 'structurally vulnerable' to mental ill health. Fewer data exist on protective factors associated with social and environmental contexts, such as social support, community attachment and a meaningful sense of place. Scholarship on the social determinants of health widely recognises the importance of such place-based factors. However, little research has examined how they shape disparities in depression and treatment specifically, limiting the development of practical approaches addressing these factors and their effects on mental well-being for rural minority populations. METHODS AND ANALYSIS: This community-driven mixed-method study uses quantitative surveys, qualitative interviews and ecological network research with 125 rural American Indian and Latinx older adults in New Mexico and 28 professional and non-professional social supporters to elucidate how place-based vulnerabilities and protective factors shape experiences of depression among older adults. Data will serve as the foundation of a community-driven plan for a multisystem intervention focused on the place-based causes of disparities in depression. Intervention Mapping will guide the intervention development process. ETHICS AND DISSEMINATION: This study has been reviewed and approved by the University of New Mexico Health Sciences Center Institutional Review Board. All participants will provide informed consent. Study results will be disseminated within the community of study through community meetings and presentations, as well as broadly via peer-reviewed journals, conference presentations and social media.
Subject(s)
Mental Health , Rural Population , Aged , Female , Humans , Male , Middle Aged , Depression/therapy , Depression/ethnology , Ethnic and Racial Minorities , Hispanic or Latino/psychology , Research Design , Social Determinants of Health , Social Support , United States , American Indian or Alaska Native/psychologyABSTRACT
For American Indians and Alaska Native (AIAN) and other communities of color, experiences with discrimination and historical trauma may contribute to healthcare system distrust and negatively affect health care decisions, including vaccination. A saturated path analysis was conducted to examine the direct and indirect associations of thoughts regarding historical losses (of culture, language, and traditional ways) and AIAN racial discrimination with historical loss associated distress, healthcare system distrust, and COVID-19 vaccine hesitancy among AIAN college students (N = 391). Historical loss thoughts and experiences with racial discrimination were strongly associated with each other, and both were uniquely associated with greater historical loss associated distress. In turn, historical loss associated distress was associated with greater healthcare system distrust, which in turn was associated with greater likelihood of being COVID-19 vaccine hesitant. While further research is needed, the findings suggest that to address health disparities for AIAN people it is necessary to consider how to best overcome healthcare system distrust and factors that contribute to it, including historical trauma and contemporary experiences with discrimination.
Subject(s)
American Indian or Alaska Native , COVID-19 Vaccines , COVID-19 , Historical Trauma , Vaccination Hesitancy , Humans , American Indian or Alaska Native/psychology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , Delivery of Health Care , Students , TrustABSTRACT
BACKGROUND: Rich cultural and traditional practices make interpersonal relationships vital for American Indian (AI) youth. Social relations and multigenerational networks (i.e., peer, family, kinship, and community) remain a salient fixture of AI culture, survival and thriving in reservation communities. Research in other populations has demonstrated how social networks impact youth risk and resilience, but data are lacking on AI adolescent networks. Intergenerational trauma from settler colonialism leads some AI youth to early initiation of substance use and subsequent substance misuse, along with disproportionately high risk for suicide and vulnerability to witnessing and experiencing violence. Using network data to develop prevention strategies among this population is a promising new avenue of research. In this study protocol paper, we describe the rationale and methodology of an exploratory study to be conducted with American Indian 9th and 10th graders at three schools on a Northern Plains reservation. METHODS: This mixed methods study will collect quantitative social network surveys (N = 300) and qualitative interviews (n = 30). The study will examine the extent to which existing social network theories and data metrics adequately characterize AI youth networks or how they may need to be expanded for this population. Associations of network characteristics with risk and protective factors for substance use, exposure to violence, and suicide will also be examined. DISCUSSION: This innovative methodological approach holds promise for informing the development of effective preventive approaches to address co-occurring risks for substance use, violence and suicide among AI adolescents. Understanding processes that impact social networks among AI adolescents can promote culturally resonant social relationships that may support better outcomes for youth.
Subject(s)
American Indian or Alaska Native , Culture , Social Support , Adolescent , Humans , American Indian or Alaska Native/psychology , Residence Characteristics , Social Support/psychology , Substance-Related Disorders/ethnology , Substance-Related Disorders/etiology , Substance-Related Disorders/prevention & control , Suicide/ethnology , Suicide/psychology , Surveys and Questionnaires , Violence/ethnology , Violence/prevention & control , Violence/psychology , Multicenter Studies as TopicABSTRACT
BACKGROUND: Identifying factors that support healthy psychological functioning after experiencing violence or other adversities in youth can lead to better prevention and intervention efforts. This is particularly important among communities with disproportionately high rates of adversity resulting from legacies of social and political injustices, such as American Indian and Alaska Native populations. METHODS: Data were pooled from four studies in the southern U.S. to examine a subsample of American Indian/Alaska Native participants (N = 147; mean age 28.54 years, SD = 16.3). Using the resilience portfolio model, we investigate the impact of three categories of psychosocial strengths (regulatory, meaning making, and interpersonal) on psychological functioning (subjective well-being and trauma symptoms), controlling for youth victimization, lifetime adversities, age, and gender. RESULTS: In examining subjective well-being, the full model accounted for 52 % of the variance, with strengths explaining more variance than adversities (45 % vs 6 %). For trauma symptoms, the full model accounted for 28 % of the variance, with strengths and adversities accounting nearly equally for the variance (14 % and 13 %). DISCUSSION: Psychological endurance and sense of purpose showed the most promise for bolstering subjective well-being while poly-strengths (having a diversity of multiple strengths) was most predictive of fewer trauma symptoms. Building psychosocial strengths offers promising strategies for prevention and intervention in Native nations and communities.
Subject(s)
American Indian or Alaska Native , Crime Victims , Resilience, Psychological , Adolescent , Adult , Humans , Alaska Natives , American Indian or Alaska Native/psychology , Crime Victims/psychology , Indians, North American/ethnology , Indians, North American/psychology , Violence/ethnology , Violence/psychology , Southeastern United States , TennesseeABSTRACT
PURPOSE: Mental health inequalities continue to persist among American Indian/Alaska Native (AI/AN) people. However, few studies have examined the association of social networks and depression and anxiety among urban emerging AI/AN adults. METHODS: This study analyzes the association of social network characteristics with depression and anxiety among a sample of urban AI/AN emerging adults. A second set of regression models tested the same associations but controlling for respondent sexual and gender minority (SGM) status. Data were from a sample of 150 AI/AN emerging adults residing in urban areas from 20 different states (86% female; mean age 21.8; 48.0% SGM) who participated in a randomized controlled trial analyzing the effects of culturally grounded interventions on alcohol and other drug use and cultural connectedness. RESULTS: Participants with a higher proportion of network members who were around the same age reported significantly less anxiety. Those who had a higher proportion of network members who they sometimes/often argue/fight with were more likely to report greater depression and anxiety. Participants with higher proportions of social network members who have ever lived on a reservation/Rancheria/tribal land/tribal village reported significantly less depression. However, participants with higher proportions of social network members who lived 50 miles away or more reported significantly more depression. Controlling for SGM status, results were largely similar. DISCUSSION: Results highlight the role of social connections on the mental well-being of urban AI/AN emerging adults.
Subject(s)
American Indian or Alaska Native , Anxiety , Depression , Social Networking , Female , Humans , Male , Young Adult , American Indian or Alaska Native/psychology , Anxiety/epidemiology , Depression/epidemiology , United StatesABSTRACT
BACKGROUND: Given high rates of cancer mortality in Native communities, we examined how urban American Indian and Alaska Native elders talk about colorectal cancer (CRC) and CRC screening. METHODS: We conducted seven focus groups with a total of 46 participants in two urban clinics in the Pacific Northwest to assess participant awareness, perceptions, and concerns about CRC and CRC screening. Using speech codes theory, we identified norms that govern when and how to talk about CRC in this population. RESULTS: Our analyses revealed that male participants often avoided screening because they perceived it as emasculating, whereas women often avoided screening because of embarrassment and past trauma resulting from sexual abuse. Both men and women used humor to mitigate the threatening nature of discussions about CRC and CRC screening. CONCLUSIONS: We offer our analytic results to assist others in developing culturally appropriate interventions to promote CRC screening among American Indians and Alaska Natives.
Subject(s)
American Indian or Alaska Native , Colorectal Neoplasms , Early Detection of Cancer , Wit and Humor as Topic , Aged , Female , Humans , Male , American Indian or Alaska Native/psychology , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/psychology , Early Detection of Cancer/psychology , Focus Groups , Urban PopulationABSTRACT
Human and nonhuman primate mother-infant dyads engage in face-to-face interactions critical for optimal infant development. In semi-free-ranging rhesus macaques (Macaca mulatta), maternal primiparity and infant sex influence the expression of nonverbal face-to-face mother-infant interactions. However, whether similar patterns of variation exist in laboratory-housed macaques or human mothers is not well understood. Comparing both species would yield information regarding the translational validity of macaques to humans in this important social/developmental domain. In this pilot study, we first compared semi-free-ranging (n = 39) and laboratory-housed (n = 20) macaques, finding that laboratory-housed dyads, first-time mothers, and mothers of sons engaged in higher rates of face-to-face interactions regardless of housing. After translating the nonhuman primate coding scheme for use in a small but diverse group of human mother-infant dyads (N = 27; 44.4% African American, 18.5% American Indian, 7.4% Asian/Asian American, and 29.6% White), we found that, like macaques, human mothers of sons engaged in more face-to-face interactions; however, experienced (vs. first-time) mothers engaged in more interactions. Macaques and humans also engaged in species-specific interactions with their infants. We conclude that components of caregiver-infant nonverbal face-to-face interactions are translatable across human and nonhuman primate species and represent an exciting avenue for future caregiving work.
Subject(s)
Child Development , Macaca mulatta , Mother-Child Relations , Animals , Child , Female , Humans , Infant , Black or African American/psychology , Macaca mulatta/growth & development , Macaca mulatta/psychology , Mother-Child Relations/ethnology , Mother-Child Relations/psychology , Mothers/psychology , Pilot Projects , Animal Communication , Facial Expression , Behavior, Animal , American Indian or Alaska Native/psychology , Asian/psychology , White/psychologyABSTRACT
BACKGROUND: In 2020 COVID-19 was the third leading cause of death in the United States. Increases in suicides, overdoses, and alcohol related deaths were seen-which make up deaths of despair. How deaths of despair compare to COVID-19 across racial, ethnic, and gender subpopulations is relatively unknown. Preliminary studies showed inequalities in COVID-19 mortality for Black and Hispanic Americans in the pandemic's onset. This study analyzes the racial, ethnic and gender disparities in years of life lost due to COVID-19 and deaths of despair (suicide, overdose, and alcohol deaths) in 2020. METHODS: This cross-sectional study calculated and compared years of life lost (YLL) due to Deaths of Despair and COVID-19 by gender, race, and ethnicity. YLL was calculated using the CDC WONDER database to pull death records based on ICD-10 codes and the Social Security Administration Period Life Table was used to get estimated life expectancy for each subpopulation. RESULTS: In 2020, COVID-19 caused 350,831 deaths and 4,405,699 YLL. By contrast, deaths of despair contributed to 178,598 deaths and 6,045,819 YLL. Men had more deaths and YLL than women due to COVID-19 and deaths of despair. Among White Americans and more than one race identification both had greater burden of deaths of despair YLL than COVID-19 YLL. However, for all other racial categories (Native American/Alaskan Native, Asian, Black/African American, Native Hawaiian/Pacific Islander) COVID-19 caused more YLL than deaths of despair. Also, Hispanic or Latino persons had disproportionately higher mortality across all causes: COVID-19 and all deaths of despair causes. CONCLUSIONS: This study found greater deaths of despair mortality burden and differences in burden across gender, race, and ethnicity in 2020. The results indicate the need to bolster behavioral health research, support mental health workforce development and education, increase access to evidence-based substance use treatment, and address systemic inequities and social determinants of deaths of despair and COVID-19.
Subject(s)
COVID-19 , Health Inequities , Mortality, Premature , Social Determinants of Health , Female , Humans , Male , COVID-19/epidemiology , COVID-19/ethnology , COVID-19/psychology , Cross-Sectional Studies , Ethanol , Ethnicity/psychology , Ethnicity/statistics & numerical data , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Suicide/ethnology , Suicide/psychology , Suicide/statistics & numerical data , United States/epidemiology , Cause of Death , Race Factors , Sex Factors , Drug Overdose/epidemiology , Drug Overdose/ethnology , Drug Overdose/mortality , Drug Overdose/psychology , Alcohol-Related Disorders/epidemiology , Alcohol-Related Disorders/ethnology , Alcohol-Related Disorders/mortality , Alcohol-Related Disorders/psychology , Black or African American/psychology , Black or African American/statistics & numerical data , Social Determinants of Health/ethnology , Social Determinants of Health/statistics & numerical data , White/psychology , White/statistics & numerical data , American Indian or Alaska Native/psychology , American Indian or Alaska Native/statistics & numerical data , Asian/psychology , Asian/statistics & numerical data , Native Hawaiian or Other Pacific Islander/psychology , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Cost of Illness , Mortality, Premature/ethnology , Life Expectancy/ethnologyABSTRACT
Historic loss and historic loss-associated symptoms were examined in a cross-section of 60 American Indian and Alaska Native students attending a Native American serving college that is also a former Indian boarding school. To measure awareness of current events regarding finding unmarked graves at boarding schools, authors developed and used the Truth and Reconciliation Scale. Levels of self-compassion were assessed in participants to determine if there was a correlation between negative feelings towards oneself and psychological risk factors brought forth as a result of how aware students were of current events surrounding former Indian boarding schools. Self-compassion was predicted to act as a protective factor and a positive coping mechanism for those most impacted by historic loss and intergenerational trauma. Participants reported thinking about, and being psychologically impacted by, historic loss. Psychological impacts were stronger in participants who were more aware of current reconciliation efforts and those who had higher levels of negative thoughts towards themselves. This suggests the possibility that current events, such as the finding of unmarked graves at former Indian boarding schools, might be increasing trauma responses in current students. Working to reduce negative thoughts about self and increase self-compassion may help buffer the negative impacts of the current truth and reconciliation work. Researchers and practitioners are encouraged to engage in more research and practice exploring the potential benefits of self-compassion for those adversely affected by historic loss, thus improving the likelihood of cultural revitalization from a broad perspective.
Subject(s)
American Indian or Alaska Native , Humans , American Indian or Alaska Native/psychology , Schools , Students/psychologyABSTRACT
BACKGROUND: American Indians have the highest prevalence of type 2 diabetes compared with any other racial or ethnic group. OBJECTIVE: Developing a culturally tailored diabetes prevention and management intervention is one way to reduce diabetes-related health disparities among American Indian populations. The purpose of this article is to describe our approach for developing a diabetes prevention and management intervention study using Kolb's Experiential Learning Theory as the framework. METHODS: To ensure the intervention study was culturally meaningful and relevant we used community-based participatory principles by partnering with a team of nurse researchers, tribal diabetes educators, tribal leaders, and tribal community members who were involved in all aspects of the study process. We conducted seven focus groups predominantly in rural American Indian communities in Oklahoma. Using focus group findings, the team collaboratively designed and developed a multi-generational diabetes prevention and management intervention study. The intervention group sessions will focus on ways to prevent and manage diabetes while the control group sessions will focus on general health education topics that have been identified by the team as important and relevant. CONCLUSIONS: Family interventions that involve multiple generations and provide emotional and behavioral support to those with type 2 diabetes and family members at risk may provide our best chance at improving diabetes-related outcomes and reducing health disparities in this critical population.
Subject(s)
American Indian or Alaska Native , Diabetes Mellitus, Type 2 , Humans , American Indian or Alaska Native/psychology , Community-Based Participatory Research , Diabetes Mellitus, Type 2/prevention & control , Focus GroupsABSTRACT
PURPOSE: The purpose of the study was to describe, compare, and examine associations at baseline of reproductive health awareness, knowledge, health beliefs, communication and behaviors related to gestational diabetes (GDM) and GDM risk reduction in a vulnerable population of both American Indian/Alaska Native (AIAN) adolescent girls and their mothers. METHODS: Descriptive/comparative/correlational analyses examined multitribal baseline data on 149 mother-daughter (M-D) dyads (N = 298; daughter age = 12-24 years) enrolled in a longitudinal study to adapt and evaluate a culturally relevant diabetes preconception counseling (PC) program (Stopping-GDM). The associations between GDM risk reduction awareness, knowledge, health beliefs, and behaviors (eg, daughters' eating, physical activity, reproductive-health [RH] choices/planning, M-D communication, daughters' discussions on PC) were examined. Data collected online from 5 national sites. RESULTS: Many M-D lacked awareness/knowledge of GDM and risk reduction. Both M-D were unaware of the girl's risk for GDM. Mothers' knowledge and beliefs on GDM prevention/RH were significantly higher than daughters. Younger daughters had greater self-efficacy healthy living. Overall sample reported low to moderate scores for both M-D communication and daughters' GDM and RH risk-reduction behaviors. CONCLUSIONS: Knowledge, communication, and behaviors to prevent GDM were low in AIAN M-D, especially daughters. More than daughters, mothers perceive greater risk of GDM for daughters. Early culturally responsive dyadic PC programs could help decrease risk of developing GDM. Implications for M-D communication is compelling.
Subject(s)
American Indian or Alaska Native , Diabetes, Gestational , Mother-Child Relations , Reproductive Health , Adolescent , Adult , Child , Female , Humans , Pregnancy , Young Adult , American Indian or Alaska Native/psychology , American Indian or Alaska Native/statistics & numerical data , Communication , Diabetes, Gestational/epidemiology , Diabetes, Gestational/ethnology , Diabetes, Gestational/prevention & control , Diabetes, Gestational/psychology , Health Knowledge, Attitudes, Practice/ethnology , Longitudinal Studies , Mother-Child Relations/ethnology , Mother-Child Relations/psychology , Mothers/psychology , Mothers/statistics & numerical data , Nuclear Family/ethnology , Nuclear Family/psychology , Reproductive Health/ethnology , Reproductive Health/statistics & numerical data , AwarenessABSTRACT
AIM: To explore the resilience of children, six to thirteen years old, living on a Northern Plains American Indian Reservation using a situation specific nursing theory. BACKGROUND: American Indian and Alaska Native children experience mental health inequities compared to their white peers, including substance use, suicide, depression, and anxiety. Resilience is a strength of children that can be leveraged to improve their mental health. DESIGN: A parallel convergent mixed methods design. METHODS: A community advisory board culturally adapted resilience instruments. During two weeks in summer 2022, forty-seven children/caregiver dyads completed surveys about the child's resilience. Descriptive statistics gave the scores of each child's personal, relational, and total resilience. A subset of 20 children participated in a semi-structured interview. RESULTS: Children scored high on overall resilience, and higher on the relational subscale than the personal subscale. Caregiver survey scores were not significantly correlated with their child's scores and were higher than the children's scores. Qualitative coding revealed six themes of resilience. Integration of data showed a concordance and expansion of the quantitative data across themes. CONCLUSION: The children reported high resilience supported by a strong ecosystem of relationships. Resilience, as explained through children's voices, corroborated with findings from the surveys. IMPLICATIONS FOR NURSING: Findings will help nurses across sectors of primary, secondary, and tertiary care create resilience-enhancing interventions and prevent mental health crises in this community. IMPACT STATEMENT: This findings from this study will inform local mental health interventions on the Reservation. The study provides a reproducible design to adapt to other Indigenous communities. PUBLIC CONTRIBUTION: A community advisory board was a partner in every stage of the study. Children and caregivers participated in data collection. CONTRIBUTION TO THE WIDER CLINICAL COMMUNITY: This research provides knowledge that will further social justice efforts within nursing to promote health equity across diverse populations.
Subject(s)
American Indian or Alaska Native , Health Inequities , Mental Health , Residence Characteristics , Resilience, Psychological , Social Determinants of Health , Adolescent , Child , Humans , American Indian or Alaska Native/psychology , Health Promotion , Indians, North American/psychology , Suicide , United States/epidemiology , Social Determinants of Health/ethnology , Advisory Committees , Cultural Competency/psychology , Mental Health/ethnology , Nursing CareABSTRACT
Reservation-area American Indian (AI) youth demonstrate higher rates of binge drinking (BD) than their non-AI peers. However, individual and school-level differences in BD disparities between reservation-area AI/non-AI female and male adolescents remain unexamined. This study applies an Intersectional framework to examine risk and protective factors of BD among reservation-area youth at the intersection of their sex and AI identities. A nationally representative sample of adolescents (N = 14,769; Mage = 14.6, 49% female; 61% AI) attending 103 reservation-serving schools completed a survey between 2015 and 2019. Multilevel modeling was used to examine differences in risk and protective factors of BD between AI and non-AI male and female adolescents. Our findings indicate that the effects of student and school-level risk and protective factors on adolescents' BD are driven primarily by sex within AI and non-AI groups. Implications for future confirmatory research and tailoring school-based prevention programs are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Subject(s)
Adolescent Behavior , American Indian or Alaska Native , Binge Drinking , Indians, North American , Social Identification , Adolescent , Female , Humans , Male , Adolescent Behavior/ethnology , American Indian or Alaska Native/education , American Indian or Alaska Native/psychology , American Indian or Alaska Native/statistics & numerical data , Binge Drinking/epidemiology , Binge Drinking/ethnology , Binge Drinking/psychology , Ethanol , Indians, North American/education , Indians, North American/ethnology , Indians, North American/psychology , Indians, North American/statistics & numerical data , Sex Factors , Neighborhood Characteristics , Intersectional Framework , Social Determinants of Health/ethnology , Social Determinants of Health/statistics & numerical data , Schools , Students , United States/epidemiologyABSTRACT
The Beck Depression Inventory-II (BDI-II) is used to assess depression with people from many cultures and ethnicities; however, the scale has been validated with very few populations other than the majority (Gray et al., 2016). Secondary analysis of data included two-factor confirmatory factor analyses (CFA) of the BDI-II with two independent American Indian samples, which were compared with the results in the BDI-II Manual (Beck et al., 1996). Sample 1 included 527 adult American Indians recruited from seven tribal communities, and Sample 2 included a community sample of 440 American Indian adults. The results of both CFA matched the original factor structure reported in Beck et al. (1996) supporting the construct validity of the BDI-II in Northern Plains American Indians. The internal consistency of the BDI-II was very high in Sample 1 (r = .94) but somewhat lower in Sample 2 (r = .72). Measures of convergent validity and discriminant validity were below acceptability for both Sample 1 and Sample 2. The results of this study support the construct validity of the BDI-II in Northern Plains American Indians. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Subject(s)
American Indian or Alaska Native , Depression , Adult , Humans , American Indian or Alaska Native/psychology , Depression/diagnosis , Factor Analysis, Statistical , Psychiatric Status Rating Scales , Psychometrics , Reproducibility of ResultsABSTRACT
Culturally relevant stressors and protective factors are vital to understanding and effectively supporting Native American/Alaska Native (NA/AN) college students' mental health and well-being. This study examined the theorized pathways among historical loss, well-being, psychological distress, and the proposed cultural buffer of ethnic identity in the indigenist stress-coping model (ISCM). Cross-sectional data were collected via online survey and analyzed using structural equation modeling. Participants were a national sample of 242 NA/AN college students. Participants were predominantly women (n = 185; 76%) and median age was 21 years. Partial support was found for the ISCM. Participants reported frequent thoughts of historical loss, which were associated with lower well-being and higher levels of psychological distress. Ethnic identity moderated the relationship between historical loss and well-being such that those with stronger ethnic identities reported a weaker relationship between historical loss and lower well-being. Results underscore the importance of culturally specific risk and protective factors in NA/AN college students' resiliency and inform needed interventions and systemic change in higher education. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Subject(s)
American Indian or Alaska Native , Historical Trauma , Mental Health , Social Determinants of Health , Social Identification , Students , Adult , Female , Humans , Male , Young Adult , Adaptation, Psychological , American Indian or Alaska Native/history , American Indian or Alaska Native/psychology , Cross-Sectional Studies , Mental Health/ethnology , Mental Health/history , Students/psychology , Universities , Protective Factors , Historical Trauma/ethnology , Historical Trauma/history , Historical Trauma/psychology , Minority Health/ethnology , Minority Health/history , Social Determinants of Health/ethnology , Social Determinants of Health/history , Resilience, Psychological , Cultural Competency/education , Cultural Competency/psychologyABSTRACT
There is limited research on ethnic-racial socialization outside the family context (e.g., in peer groups). Using two-week, daily data from 177 U.S. ethnic-racial minority 9th graders in 2017-2020 (Mage = 14.48 years old; 51% females; 52% Black, 20% Latinx, 10% Asian American, 6% Native American, and 12% Other), this study tested a transactional model of family and peer ethnic-racial socialization, identity, and discrimination. Bidirectional associations were observed between family and peer cultural socialization across days (ßs = .09-.10). Peer but not family cultural socialization promoted adolescents' ethnic-racial identity on the next day (ßs = .07-.10). Ethnic-racial discrimination predicted greater next-day family ethnic-racial socialization (cultural socialization, preparation for bias; ßs = .08-.11), whereas family and peer ethnic-racial socialization predicted next-day discrimination (ßs = .11-.18). The differential roles of family and peer ethnic-racial socialization are discussed.