Resiliency and American Indian Youth Health Risk Behavior: Protective Patterns and Trends from the Southwest Tribal Youth Project

Background:  Health-risk behaviors are often established during childhood, extend into adulthood and are preventable. Valid and timely information about these risk behaviors and protective resiliency factors among American Indian/Alaska Native (AI/AN) youth is critical.  Methods:  Since 2007, the Albuquerque Area Southwest Tribal Epidemiology Center has conducted a classroom census of the biennial New Mexico Youth Risk and Resiliency Survey (NMYRRS) in middle and high schools with large AI/AN student enrollments.  For 2011 data, bivariate and multivariate analyses were calculated to characterize health risk behavior and resiliency among AI/AN youth and assess the protective influence of resiliency factors upon four prevalent risk behaviors– suicidality, alcohol, marijuana and tobacco use.  Results: The project significantly increased AI/AN representation in the NMYRRS with an additional 594, 1,985, 3,471, and 4,296 AI/AN youth added to the statewide sample in 2007, 2009, 2011 and 2013 respectively.  Common resiliency factors among AI/AN youth were caring/supportive relationships (81.7% middle school; 68.8% high school), extracurricular activity participation (60.7% middle school; 51.3% high school), and high academic achievement (58.7% middle school; 56.6% high school).  These resiliency factors also significantly mitigated health risk behaviors.  For example, AI/AN high school youth with ample caring/supportive relationships were 1.8, 2.5, 2.6, and 2.9 times less likely to experience suicide issues, alcohol, tobacco, and marijuana use respectively.  Conclusions:  Surveillance of health risk behaviors and resiliency among AI/AN youth is feasible and valuable towards the identification of key resiliency factors which can serve as intervention leverage points to protect AI/AN youth from adverse health risk behaviors.