Acceptability of an eHealth Intervention to Prevent Alcohol-Exposed Pregnancy Among American Indian/Alaska Native Teens.

BACKGROUND: A tribally led Changing High-Risk Alcohol Use and Increasing Contraception Effectiveness Study (CHOICES) Program has successfully decreased the risk of alcohol-exposed pregnancies (AEPs) among adult American Indian/Alaska Native (AI/AN) women by either reducing risky drinking or increasing contraception use. However, a community needs assessment revealed a need to implement a similar intervention with AI/AN teens. The goal of the project was to develop and establish the acceptability of CHOICES for AI/AN teens. METHODS: Key informant interviews were conducted to review the existing OST CHOICES intervention. After modifications to the existing program, focus groups with AI/AN teens were conducted to ensure validity and to finalize the OST CHAT (CHOICES for American Indian Teens) intervention. RESULTS: Key informant (N = 15) participants suggested that a Web-based intervention may increase teen engagement by making the intervention more interactive and visually stimulating. Based on this formative research, CHAT was developed via Research Electronic Data Capture (REDCap). Feedback on the online CHAT curriculum was given by focus groups comprised of AI/AN adolescents, and participants felt that this type of intervention would be both acceptable and able to implement with a community of reservation-based teens. CONCLUSIONS: This study outlines the development of a Web-based intervention for an AEP intervention for AI/AN teens and will inform future prevention efforts. Implications include an expansion of the evidence-based CHOICES intervention for AI/AN teens and also development of a Web-based intervention for rural, reservation-based AI/AN communities.

Improving Hepatitis C Screening in the Baby Boomer Birth Cohort in Rural South Dakota: A Medical Student HQIP Project.

Hepatitis C is a bloodborne viral infection that often leads to liver disease. Individuals born between 1945-1965 (baby boomer birth cohort) are five times more likely to have hepatitis C than other age groups due to blood transfusions and medical procedures performed before the discovery of the virus. The Centers for Disease Control and Prevention and the U.S. Preventive Services Task Force recommend a one-time screening for individuals in the baby boomer birth cohort. Even with these recommendations, national screening rates remain low at around 13 percent, suggesting a need for improvement. In this study we reviewed the electronic medical record (EMR) data for a rural primary care clinic and determined the percentage of individuals screened in the baby boomer birth cohort in a one-year time period. Interventions (provider/nursing education, community education) were implemented over a four-month period. We compared the EMR data from before, during, and after interventions. Pearson's chi-squared analysis was used to evaluate differences in proportions. The results showed no statistical significance between the three timeframes measured (p-value 0.6164). We can conclude that the interventions used in this study were not adequate in producing a statistically significant change in the percentage of baby boomers screened at our local clinic. These results could be due to interventions not being implemented simultaneously, lack of follow-up with staff regarding interventions, and a short time frame for measuring post-intervention changes. Future projects may benefit from modifying interventions and their implementation.

Examining the Prevalence and Impact of Peer Victimization and Social Support for Rural Youth.

INTRODUCTION: Peer victimization is a common experience in early adolescence often associated with psychosocial issues, following some youth into adulthood. Preliminary findings from a longitudinal study on peer victimization and protective factors were measured in rural elementary youth. Bullying is often seen as a schoolonly issue but research findings suggest the importance of systems outside the school setting as important protective factors for intervention. METHODS: Preliminary data were collected through online questionnaires focused on direct, relational, and electronic victimization. Protective factors, including parent and community support, were also measured. Participants include 307 children (52.8 percent female; 80.4 percent White; mean age = 10) attending the fourth and fifth grade at four rural, South Dakota public school districts. RESULTS: Overall, 91.2 percent of the sample reported at least one peer victimization experience during the first wave of data collection. Traditional victimization results include 57.7 percent citing direct and 89.5 percent relational. Electronic victimization was 25.3 percent. Participants reported high levels of community (94.8 percent) and parent (68.3 percent) support. Community support was significantly, negatively correlated with all types of victimization but parent support was only significant in relation to direct victimization. CONCLUSIONS: Findings provide an important baseline of the prevalence of direct, relational, and electronic victimization among rural young adolescents and the importance of community and parent support. Results demonstrate the need for a community wide approach including, health care providers, to take an active role to prevent and assist affected youth.