Participant Perceptions of the Acceptability, Feasibility, and Perceived Impact of the Thiwáhe Gluwáš'akapi Substance Use Prevention Program for American Indian Youth.

(1) Background: This study aimed to examine adult participants perceptions of the Thiwáhe Gluwáš'akapi (TG) program. We recruited 13 of 85 (15.3%) adult participants from various previous cohorts of the TG program, separated into lower and higher participation groups.

Obstetric Anesthesia Workforce Survey: Forty-year Update.

Background: For 40 yr, Obstetric Anesthesia Workforce Surveys have been used every decade to assess trends in obstetric anesthesia practice and potential areas for improvement. Anesthesia providers from U.S.

Culture and COVID-19 Related Impacts on Alcohol-Exposed Pregnancy Risk Among Urban American Indian and Alaska Native Young Adults: A Path Analysis.

Purpose: We investigated the influence of COVID-19 pandemic-related factors and cultural identification on indicators of alcohol-exposed pregnancy (AEP) risk among urban American Indian and Alaska Native (AIAN) youth ages 16-20.

Methods: Path analysis was used to evaluate associations among measures collected at baseline of the Native WYSE CHOICES, an intervention study to reduce AEP risk among urban AIAN youth. Data were collected nationally from 439 female-at-birth AIAN youth (mean age 18.

One-month outcomes of a culturally tailored alcohol-exposed pregnancy prevention mobile app among urban Native young women: A randomized controlled trial of Native WYSE CHOICES.

Background: The majority of alcohol-exposed pregnancy (AEP) prevention programs for Native women have focused on at-risk adult women residing in rural tribal communities; however, over 70% of the Native population resides in urban areas. Moreover, Native young women universally-regardless of risk status-may benefit from culturally tailored resources. We hypothesized that urban Native young women who engaged with Native WYSE CHOICES (NWC), a culturally tailored AEP prevention intervention delivered by mobile phone app, would report reduced risk of AEP at the 1-month follow-up compared to those who engaged with a comparison condition.

Flexibility and resilience in equity-centered research: lessons learned conducting a randomized controlled trial of a family-based substance use prevention program for American Indian families.

Meaningful and effective community engagement lies at the core of equity-centered research, which is a powerful tool for addressing health disparities in American Indian (AI) communities. It is essential for centering Indigenous wisdom as a source of solutions and disrupting Western-centric perspectives and inequitable and exclusionary research practices. This paper reports on lessons learned implementing an effectiveness trial of the Thiwáhe Glúwaš'akapi program (TG) program (translated as "sacred home in which families are made strong")-a family-based substance use prevention program-in a post-pandemic era with an American Indian reservation community that has confronted extreme challenges.

Co-creating a conceptual model of Indigenous relational wellbeing in early childhood: Planting seeds of connectedness.

The purpose of this article is to share our story of conceptualizing Indigenous early relational wellbeing (ERW), specifically reflecting American Indian and Alaska Native worldviews. Our approach is grounded in Indigenous methodologies and guided by a Community of Learning comprised of Indigenous and allied Tribal early childhood community partners, researchers, practitioners, and federal funders. We describe the steps we took to conceptualize caregiver-child relationships from an Indigenous perspective, center Indigenous values of child development, apply an established Indigenous connectedness framework to early childhood, and co-create a conceptual model of Indigenous ERW to guide future practice and research.

Creating a Virtual Indigenist Community-Based Participatory Approach: Lessons Learned from Centering Urban Native Young Women in Research.

Community-based participatory research (CBPR) focuses on building relationships between academic and community partners. Indigenist CBPR (ICBPR) expands CBPR to elevate Native voices and center Native priorities in research. This approach, however, has historically been grounded in in-person connection and collaboration.

Looking Cool, Doing Tricks, Managing Stress, and Nicotine Addiction: Youth Perspectives on Nicotine Vaping and Implications for Prevention.

Purpose: To understand the contextual and psychosocial factors associated with youth vaping in Colorado, the state with the highest youth vaping rates in 2019, and to propose strategies for prevention interventions.

Design: Focus groups.

Setting: In-person.

Centering culture in an mHealth adaptation of an alcohol-exposed pregnancy prevention program for American Indian Youth.

Native WYSE CHOICES adapted an Alcohol Exposed Pregnancy (AEP) prevention curriculum for mobile health delivery for young urban American Indian and Alaska Native (AIAN) women. This qualitative study explored the relevance of culture in adapting a health intervention with a national sample of urban AIAN youth. In total, the team conducted 29 interviews across three iterative rounds.

Grounding evidence-based prevention within cultural context: promising effects of substance use prevention adapted for American Indian families.

: Effective substance use prevention strategies are needed for American Indian (AI) youth, who face disproportionate risk for early substance use and consequently bear a disproportionate burden of health and developmental disparities related to early use. With few exceptions, significant advances in prevention science have largely excluded this population, leaving gaps in the evidence of effective practice. This paper builds on emerging efforts to address this gap, reporting first outcome findings from an evidence-based early substance use prevention program culturally adapted for young adolescents on a Northern Plains reservation.

A virtual randomized controlled trial of an alcohol-exposed pregnancy prevention mobile app with urban American Indian and Alaska Native young women: Native WYSE CHOICES rationale, design, and methods.

Background: Fetal Alcohol Spectrum Disorders (FASD) result in lifelong disability and are a leading cause of preventable birth defects in the US, including for American Indian and Alaska Natives (AIANs). Prevention of alcohol exposed pregnancies (AEPs), which can cause FASD, is typically aimed at adult women who are risky drinkers and have unprotected sex. Among AIANs, AEP prevention research has been primarily conducted in reservation communities, even though over 70% of AIANs live in urban areas.

Measure of Socialization of American Indian Children (MOSAIC): Understanding the roots of ethnic-racial identity.

Objectives: The Measure of Socialization of American Indian Children (MOSAIC) was created as part of a larger study developing a family-based and culturally grounded substance use prevention program for young American Indian (AI) adolescents. The MOSAIC was designed to measure ethnic-racial socialization (ERS) for use with AI families to support better understanding of the roots of ethnic-racial identity among AI youth and their relationship to risk for substance use in early adolescence.

Method: This study was conducted in partnership with a Lakota reservation community.

Reducing Youth Vaping: A Pilot Test of the Peer-Led "Youth Engaged Strategies for Changing Adolescent Norms!" (YES-CAN!) Program.

Effective prevention interventions are needed to stem the rising tide of nicotine vaping among adolescents. We conducted a quasi-experimental, non-equivalent comparison group pilot study of the effectiveness of the "Youth Engaged Strategies for Changing Adolescent Norms" (YES-CAN!) program for reducing risks for youth nicotine vaping. YES-CAN! is an innovative peer-led program that supports older adolescents in developing and delivering short narrative prevention videos and related prevention education to younger adolescents.

Community perspectives on developmental screening of American Indian and Alaska Native children.

Children are highly regarded and treasured as the future of American Indian and Alaska Native (AIAN) communities. Developmental disorders, however, are more frequently undiagnosed and untreated in AIAN children compared to others in the United States. Developmental screening can help communities ensure that their children reach their full potential, but lack of culturally sensitive and valid screening measures complicates screening among AIAN children.

Exploring the feasibility of validating early developmental screening tools for American Indian and Alaska Native children.

Screening children from birth through age 5 is critical to early identification of challenges and referral to intervention to support optimal development. Screening of American Indian and Alaska Native (AIAN) children lags behind that of other children, partly due to the lack of screening tools validated for this population. This study tested the feasibility of an online data collection strategy for use in a future study of the validity of existing screening instruments for AIAN children.

Design and Effectiveness of the Youth Engaged Strategies for Changing Adolescent Norms! (YES-CAN!) Program for Reducing Skin Cancer Risk.

Adolescence is a critical period for reducing skin cancer risks, yet the development of effective interventions for middle and high school youth has lagged behind those for younger children. We developed and implemented the "Youth Engaged Strategies for Changing Adolescent Norms!" (YESCAN!) program, a school-based peer leader program that uses a youth-researcher partnership approach and a project-based curriculum to support high school students in developing and delivering short narrative videos and related material about skin cancer prevention to middle school students. Participating middle and high school students completed pre- and post-program surveys assessing skin cancer attitudes, perceived norms, and behavioral intentions.

Crisis-Resilient and Antiracist Approaches to Community-Based Participatory Research During COVID-19 and Beyond.

Social and health inequities among communities of color are deeply embedded in the United States and were exacerbated by the COVID-19 pandemic. Community-based participatory research (CBPR) is a powerful approach to advance health equity. However, emergencies both as global as a pandemic or as local as a forest fire have the power to interrupt research programs and weaken community relationships.

Community-Led Health Promotion Groups in a Bhutanese-Nepali Refugee Community.

This practice note reports on the work of the Namaste Community Health Partnership, an academic-community partnership established to address health disparities in a metro-area Bhutanese-Nepali refugee community in the western United States. Partners worked together to develop, implement, and evaluate a culturally-tailored health promotion program where Bhutanese-Nepali individuals led weekly walking groups and shared health promotion information and behavior change tools with community participants. The program was implemented with approximately 70 community members across two metro-area neighborhoods and two adult day care centers serving elders.

Making it stick: use of active learning strategies in continuing medical education.

Background: Despite the known benefits of active learning (AL), the predominate educational format in higher education is the lecture. The reasons for slow adaptation of AL in medical education are not well understood. The purpose of this survey was to determine knowledge, usage, attitudes, and barriers to AL use in academic Continuing Medical Education (CME).

Health outcomes in a national sample of American Indian and Alaska Native adults: Differences between multiple-race and single-race subgroups.

Objectives: To determine differences among multi-race (MR) American Indian and Alaska Natives (AIAN), single race (SR) AIANs, and SR-Whites on multiple health outcomes. We tested the following hypotheses: MR-AIANs will have worse health outcomes than SR-AIANs; SR-AIANs will have worse health outcomes than SR-Whites; MR-AIANs will have worse health outcomes than SR-Whites.

Methods: Behavioral Risk Factor Surveillance System data were used to examine general health, risk behaviors, access to health care, and diagnosed chronic health conditions.

Rural and Urban American Indian and Alaska Native Veteran Health Disparities: a Population-Based Study.

The health service ecology varies considerably across urban-rural divides for American Indian and Alaska Native (AIAN) veterans, which may place rural AIAN veterans at high risk for poor health outcomes. Using the Behavioral Risk Factor Surveillance System 2011 and 2012 data for its detailed race information, we employed adjusted multinomial logistical regression analyses to estimate differences in health outcomes among rural AIAN veterans (n = 1500) and urban AIAN veterans (n = 1567). We used rural White (n = 32,316) and urban White (n = 59,849) veteran samples as comparators.

Moving the prevention timeline: A scoping review of the literature on precursors to sexual risk in early adolescence among youth of color.

Introduction: Sexual health disparities are leading causes of morbidity among youth of color in the United States. We conducted a scoping review of the literature on precursors to sexual risk-taking among young adolescents of color (ages 10-14) to assess precedents of sexual experience and their utility as measurable proximal constructs and behaviors gauging sexual risk and sexual risk prevention efforts.

Methods: This study was conducted using the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines.

Patterns of use and perceptions of an institution-specific antibiotic stewardship application among emergency department and urgent care clinicians.

We surveyed emergency department and urgent care clinicians to assess patterns of use and perceived usefulness of a local antibiotic stewardship application to deliver institution-specific prescribing guidance. Among 114 eligible respondents, the application was widely utilized, and it was perceived to be a useful clinical resource that improved prescribing.

Integrating Community-Engagement and a Multiphase Optimization Strategy Framework: Adapting Substance Use Prevention for American Indian Families.

Initiation of substance use often occurs earlier among American Indian (AI) youth than among other youth in the USA, bringing increased risk for a variety of poor health and developmental outcomes. Effective prevention strategies are needed, but the evidence base remains thin for this population. Research makes clear that prevention strategies need to be culturally coherent; programs with an evidence base in one population cannot be assumed to be effective in another.

Frequent residential mobility among American Indians and early indications of sexual risk among young adolescents.

American Indian and Alaska Native (AI/AN) youth are more likely to ever have had sex, and to have engaged in sexual activity prior to age 13 compared to all other race groups. It is essential to understand the development of skills to refuse sexual experience in early adolescence in order to reduce disparities associated with early sexual debut among AI/AN youth. Familial, social, and individual factors can act as protective influences on adolescent sexual experience; however, in other settings, research has shown that frequent residential mobility disrupts these protective influences and may increase the likelihood of adolescent sexual activity.