Abstract
Centering Aaniiih and Nakoda youth voice: Qualitative description of Aaniiih and Nakoda youth perspectives on Native youth suicide
Michelle Kahn-John, PhD, RN, PMHNP-BC, GNP1, Meenakshi Richardson, MPH2, Amy Stiffarm, PhD3 and Teresa Brockie, PhD4
(1)Tucson, AZ, (2)Washington State University, Seattle, WA, (3)University of North Dakota, Grand Forks, ND, (4)Johns Hopkins School of Nursing, Baltimore, MD
APHA 2024 Annual Meeting and Expo
Background: The complex experience of Native American Youth suicide results in unrelenting community wide emotional distress and grief. In Montana, Native American Youth suicide occurs at a rate five times the statewide rate. Native Americans are underrepresented in data collection infrastructure, making it difficult for tribes, states, and the federal government to provide relevant community led health and social programming. Perspectives directly from Native American youth are also extremely unrepresented. This community-based partnership with the Fort Belknap community enhances our understanding of perspectives and experiences on mental illness, suicideAaniiih and Nakoda youth. Method: A qualitative descriptive study engaged Aaniiih and Nakoda youth, ages 14-24 to participate in 5 focus groups (N=27). Focus groups were audio-recorded, transcribed and de-identified prior to undergoing thematic analyses using NVivo software. Results: Themes identified: Strong for a reason: Holistic youth experience; Honor the truth: Impact of settler-colonialism and risk; Fractured relationality and kinship; Culturally Rooted: Pathways to living and healing; Collective rebuilding beyond grief. Discussion: Native American youth suicide is related to complex factors including historical events, family and community dynamics, priorities of leadership, validation and visibility of youth, access to resources, culturally safe prevention and intervention and post-vention solutions. To address youth suicide, youth indicate timing of interventions, authentic and culturally aware service providers, elimination of stigma related to mental illness and treatment, enhancement of community-wide education on mental illness and use of culturally derived health interventions were important considerations.
Assessment of individual and community needs for health education Diversity and culture Planning of health education strategies, interventions, and programs Program planning Public health or related nursing Public health or related research
Abstract
American Indian youth leading the fight against vaping in rural communities: A multi-pronged approach
Claradina Soto, PhD, MPH1, Prescilla Cobian, BA1, Sarah Keller, MPH, CHES1, April Go Forth, PhD2, Lisa Craig, BA2 and Guadalupe Ramos, PhD1
(1)University of Southern California, Los Angeles, CA, (2)Resources for Indian Student Education, Alturas, CA
APHA 2024 Annual Meeting and Expo
Background: American Indian (AI) middle and high school students vape more than youth from other racial and ethnic groups. Schools’ zero tolerance tobacco policies result in suspension, alienating youth, disrupting education, and negatively impacting behavior. Additionally, AI stakeholders (i.e., parents, community members) lack awareness of the sociocultural factors influencing youth vaping. In rural communities with limited resources, inequities are heightened, and multi-pronged efforts to offer youth-led, culturally sensitive interventions are warranted.
Methods: The University of Southern California and Resources for Indian Student Education (RISE) partnered with the Modoc County School District to culturally adapt and pilot the Nicotine Dependence: Education, Prevention, Tobacco, and Health (INDEPTH) intervention. A vaping educational presentation for stakeholders was also developed and piloted. Focus groups informed the adaptations and pilots. A youth advisory team and a community advisory board comprised of Tribal leaders, stakeholders, and school staff also supported this work. The 5-week intervention was piloted with 32 middle and high school students. Pre-and-post surveys assessed changes in vaping-related beliefs, attitudes, norms, and intentions to quit. The vaping presentation was assessed qualitatively with 39 stakeholders.
Results: Significant changes in beliefs about vaping’s safety and norms emerged, along with increases in ceremonial tobacco knowledge, intentions to quit, and agency to vape. Stakeholders recommended providing regionally specific epidemiological data, strategies to discuss vaping with youth, and utilizing AI messages and imagery.
Conclusions: Prevention programs are imperative given the higher risk of lifetime commercial tobacco use among this population. This multipronged approach provides necessary accessible information and early intervention.
Diversity and culture Implementation of health education strategies, interventions and programs Program planning Public health or related research Social and behavioral sciences
Abstract
Healthy native youth implementation toolbox: Using online decision support to enable AI/an communities to adopt and implement culturally-relevant, holistic, evidence-based adolescent health promotion programs
Christine Markham, PhD1, Stephanie Craig Rushing, PhD2, Michelle Singer2, Gwenda Gorman3, Connie Jessen, MA4, Melissa Peskin5, Amrita Sidhu, PHD(c), MDS, MPH6, Belinda Hernandez, PhD7 and Ross Shegog, PhD8
(1)The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, (2)Northwest Portland Area Indian Health Board, Portland, OR, (3)Inter Tribal Council of Arizona, Inc., Phoenix, AZ, (4)Alaska Native Tribal Health Consortium, Anchorage, AK, (5)University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, (6)UTHealth Houston School of Public Health, Houston, TX, (7)University of Texas Health Science Center Houston School of Public Health, Houston, TX, (8)UTHealth School of Public Health Houston, Houston, TX
APHA 2024 Annual Meeting and Expo
Background: American Indian and Alaska Native (AI/AN) youth experience serious health disparities, including elevated suicide and teen birth rates compared to their racial/ethnic peers. A growing number of evidence-based interventions that integrate the strengths and cultural teachings of Native communities exist. However, this evidence is insufficient to ensure their adoption and implementation in Native communities.
Purpose: To describe uptake of an innovative online decision support to guide AI/AN communities to adopt, implement, and maintain culturally-relevant, holistic adolescent health promotion evidence-based intervention.
Methods: Using an iterative design process, incorporating input from Native practitioners and academicians, we adapted a theory- and evidence-based online decision support system, iCHAMPSS (CHoosing And Maintaining Effective Programs for Sex Education in Schools), for Native communities. User engagement and geographic reach (January 2022-2024) were assessed using Google analytics.
Results: The Healthy Native Youth (HNY) Implementation Toolbox provides tools, templates, and guidance to plan, implement and grow a culturally-relevant, holistic adolescent health program with your community. The Toolbox comprises: 1) 19+ culturally-relevant, health promotion programs for AI/AN youth, 2) a ‘resource tools library’ comprising 20+ support tools, templates, helpful tips, and links to online resources, and 3) stories from the field (testimonials from experienced Native health educators). As of January 2024, the Toolbox has had 4,564 page views, added 2,566 new visitors (66% female; 25-44 years (60%) and reached 10 states (mainly CA, WA, and AL).
Conclusion: The HNY Implementation Toolbox represents an acceptable, feasible implementation strategy to increase culturally relevant holistic adolescent health promotion programming in AI/AN communities.
Administer health education strategies, interventions and programs Advocacy for health and health education Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related education
Abstract
Canoe journeys: Climate change, culture and healing for native youth in the Pacific Northwest
Tia Benally, MPH1, Stevey Seymour2, Maya Magarati, PhD1, Kimy Peterson3, Marina Van Pelt1, Jacob Fong-Gurzinsky, MS1, Jamie Lan1 and Myra Parker, JD/MPH, PhD1
(1)University of Washington, Seattle, WA, (2)Inchelium Language & Culture Association, Inchelium, WA, (3)Children of the Setting Sun, Bellingham, WA
APHA 2024 Annual Meeting and Expo
, an Indigenous Public Health Institute at the University of Washington, partnered with two Native-led non-profit organizations in the Pacific Northwest for the 2023 Canoe Journey pilot research project. Researchers collaborated with community partners to conduct interviews, focus groups, and collected additional data through surveys. Further, community partners were involved in the entire process of research implementation, data analysis and interpretation to ensure Indigenous Data Sovereignty. Partners were able to provide contextual insight from their lived experiences and knowledge from being part of and working with the Indigenous youth from their communities. This mixed-methods pilot explored Indigenous youth perceptions of Canoe Journey and relationships between mental health and wellness, climate change, cultural and community connectedness, and resiliency. Initial findings include ways Canoe Journey participation increased youth connection to culture, environment, peer and community support, and the promotion of health and wellbeing. Additionally, youth shared the impact of Canoe Journey on mental health and their interest in having support with connection to resources. This research project prioritized building trust and establishing a strong relationship with community partners to ensure the research aligned with tribal community priorities. This study exemplifies the focus on rebuilding trust in public health and science by offering concrete examples of how a community based participatory approach can strengthen community connections, ensure community voice in research, and support community capacity building.
Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Public health or related education Public health or related research Social and behavioral sciences Systems thinking models (conceptual and theoretical models), applications related to public health
Abstract
Photovoice as an effective strategy in communicating cancer health equity in American Indian youth: The southeastern American Indian cancer health equity partnership (SAICEP)
Ronny Bell, PhD, MS1, Robert Strack, PhD2, Charlene Hunt, BS3, Muhsin Orsini, PhD2, Stephanie Wheeler, PhD4, Tomi Akinyemiju, PhD5, Carla Strom, MLA3 and Rachel Denlinger-Apte, PhD, MPH6
(1)Eshelman School of Pharmacy, UNC Chapel Hill, Chapel Hill, NC, (2)University of North Carolina at Greensboro, Greensboro, NC, (3)Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, (4)Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, (5)Duke University, Durham, NC, (6)Wake Forest University School of Medicine, Winston-Salem, NC
APHA 2024 Annual Meeting and Expo
American Indians experience significant cancer disparities, driven by harmful tobacco use and adverse social determinants of health. Achieving cancer health equity in Native communities requires strategies that respect cultural norms and engages tribal citizens. In 2021, the Southeastern American Indian Cancer health Equity Partnership (SAICEP) was launched as a collaboration between the Community Outreach and Engagement programs at the three NCI-designated Comprehensive Cancer Centers in North Carolina with the goal of understanding and addressing the cancer-related health needs of the eight tribals and four urban Indian centers in the state. Funded by a V Foundation grant, SAICEP engaged the Executive Council of the North Carolina Native American Youth Organization (NCNAYO) to conduct a photovoice project to understand cancer perceptions in their tribal communities. NCNAYO participants were trained in photovoice techniques using a traditional Talking Circle framework and instructed to capture photos and write their thoughts from their photos taken in their communities. Prompts provided to participants included: 1) What factors in your tribal community make it easier to avoid cancer? 2) What obstacles within your tribal community make it hard to avoid cancer? and, 3) What does cancer look like in your community? Positive themes that emerged included the importance of faith and spirituality, Native culture and American Indian health care providers in their community. Negative themes included the easy access to tobacco products the availability of smoke and vape shops in their communities. Findings from this project will guide SAICEP in developing culturally-respectful cancer health equity strategies.
Diversity and culture Public health or related education Public health or related research
Abstract
Discussion
APHA 2024 Annual Meeting and Expo