Culturally focused wellness intervention for American Indian women of a small southwest community: associations with alcohol use, abstinence self-efficacy, symptoms of depression, and self-esteem.

PURPOSE: This study examined the influence of a culturally focused wellness intervention on alcohol consumption, alcohol abstinence self-efficacy, depression, and self-esteem among women of a small American Indian community in the southwestern United States. Participation in two intervention approaches was compared: a curriculum-based health promotion­only approach and health promotion combined with cognitive-behavioral skills building (CBSB). DESIGN: The wellness intervention was tested in a prospective, randomized, two-group design with repeated measures. There was no control group. SETTING: An American Indian community in the Southwest. SUBJECTS: American Indian women, ages 18 to 50 (N = 268). INTERVENTION: A 10-session culturally focused curriculum-based health promotion intervention, with a CBSB component, was developed using a community-based participatory research process. Comparisons were made between those who attended the health promotion plus CBSB intervention and those who attended the intervention without the CBSB component. MEASURES: Information regarding demographics, substance use, alcohol consumption, alcohol abstinence self-efficacy, depressive symptoms, and self-esteem was collected through a structured interview. ANALYSIS: Regression was used to evaluate the effect of the intervention on alcohol consumption, alcohol abstinence self-efficacy, depressive symptoms, and self-esteem in CBSB and non-CBSB groups. RESULTS: Although there were no significant differences between the CBSB and non-CBSB groups, the results indicate a significant decrease in alcohol consumption and symptoms of depression, and a significant increase in alcohol abstinence self-efficacy and self-esteem, from baseline to the 6-month follow-up for both groups. CONCLUSION: Evidence suggests that this culturally focused health promotion intervention has a positive impact on alcohol use, alcohol abstinence self-efficacy, depressive symptoms, and self-esteem among American Indian women.

Integration of creative expression into community-based participatory research and health promotion with Native Americans.

Involvement in creative expression has the potential of engaging individuals in personal- and community-level change through reflection, empowerment, and the facilitation of connectedness. It is a process that can be a powerful component of community-based participatory research, as it can facilitate and support the principles of co-learning, egalitarian relationships, and respect for nonacademic knowledge. It is also a valuable means of appreciating culture and strengthening identity, which enhances health. This article reviews and discusses methods and benefits of incorporating creative expression into health promotion programs and community-based participatory research with Native Americans.