American Indian and Alaska Native Mental Health Research

American Indian and Alaska Native (AI/AN) young adults are strong and resilient. Interventions designed to improve their mental health and help-seeking skills are especially needed, particularly those that include culturally relevant resources and relatable role models. This paper presents formative research from the BRAVE study, a five-year community based participatory research project led by the Northwest Portland Area Indian Health Board. Formative research included three phases and more than 38 AI/AN young adults and content experts from across the United States. Results indicate that behavioral interventions can be feasibly delivered via text message to AI/AN young adults and that including Native youth in the formative research is critical to designing a comprehensive, culturally-responsive intervention. Lessons learned from this five-year process may help other youth-serving organizations, prevention programs, policymakers, researchers, and educators as they support the next generation of AI/AN leaders.

Stephanie Craig Rushing

Allyson Kelley

Steven Hafner

David Stephens

Michelle Singer

Dyani Bingham

Colbie Caughlan

Bethany Fatupaito

Amanda Gaston

Thomas Ghost Dog

Paige Smith

Danica Love Brown

Celena McCray

The BRAVE Study: Formative Research to Design a Multimedia Intervention for American Indian and Alaska Native Young Adults

BRAVE研究：为美国印第安和阿拉斯加原住民年轻成人设计多媒体干预的形成性研究

In this study, positive aspects of self-compassion (i.e., self-kindness, common humanity, and mindfulness of one's thoughts and feelings) were explored in relation with suicide risk factors (i.e., perceived burdensomeness and thwarted belongingness) in a community sample of 242 self-identified American Indian/Alaska Native (AI/AN) adults. Participants completed a survey packet including a demographic form, the Interpersonal Needs Questionnaire, and the Self-Compassion Scale at several Indian Health Service clinics and tribal centers in the Great Plains of the United States. Results indicated that positive aspects of self-compassion (i.e., self-kindness, common humanity, and mindfulness) were associated with and predictive of less suicide risk (i.e., less perceived burdensomeness and thwarted belongingness) among AI/AN adults. Of those with a history of suicidal ideation (n = 89), positive aspects of self-compassion were predictive of less perceived burdensomeness, but were not predictive of thwarted belongingness. Implications for prevention and intervention programs that emphasize self-compassion, mindfulness, and culturally relevant practices, as well as mental health advocacy, including suicide prevention, for AI/AN people are highlighted.

Sarah Dolezal

Carrie Winterowd

Aisha Farra

The Relationship of Self-Compassion and Suicide Risk Factors in American Indian/Alaska Native People

美国印第安/阿拉斯加原住民人群中自我同情与自杀风险因素的关系

Increasing rates of opioid-related deaths over the last twenty years have created a national public health crisis. However, minimal research investigates opioid use among American Indian and Alaska Native (AI/AN) youth. This study examined non-medical prescription opioid prevalence rates and resiliency of urban and rural AI/AN and non-AI/AN students. The sample included eighth, tenth, and twelfth grade students who participated in the New Mexico Youth Risk and Resilience Survey in 2013, 2015, and 2017 (n = 42,098). Logistic regression models showed no significant differences in non-medical prescription opioid use among rural and urban students in 2013, 2015, and 2017. No significant differences in use between AI/AN and non-AI/AN students occurred in 2013, 2015, or 2017. Family and community support were protective of misuse consistent across time points, and included caring adults, community involvement, and clear rules at school. These findings may help to inform the development of strengths-based prevention activities for AI/AN youth.

Katherine Hirchak

Solmaz Amiri

Judith Espinoza

Jalene Herron

Alexandra Hernandez-Vallant

Violette Cloud

Kamilla Venner

Trends in Non-Medical Prescription Opioid Use among Urban and Rural American Indian and Alaska Native Youth Residing in New Mexico: 2013-2017

新墨西哥州居住的城市和农村美国印第安和阿拉斯加原住民青年非医疗处方阿片类药物使用趋势：2013-2017年

Historical trauma has contributed to the reality that addiction disproportionately affects tribal communities, including American Indian youth. We sought to understand American Indian youths' own experiences and perceptions of the environments to which they return after completing residential treatment for substance use disorder. We recruited three cohorts of American Indian residents of a substance use disorder treatment facility (N = 40). These residents completed a survey that measured risk and protective factors, as well as actual risk behaviors, including drug use, gambling, and violence. Participants were at risk not only for substance use disorders, but for other negative outcomes, and had elevated scores on several community, family, and school risk factors, including perceived availability of drugs, community disorganization, family history of antisocial behavior, favorable parental attitudes toward drug use, academic failure, and low school commitment. At the same time, they were exposed to community-level and family protective factors, and they engaged in many tribal cultural activities. When compared to a national sample of American Indian students of similar age, youth in our sample scored similarly on protective factors, including indicators of community, family, and school opportunities and rewards for prosocial involvement, as well as family attachment, suggesting potential resources and strengths for supporting recovery.

Debi LaPlante

Martina Whelshula

Heather Gray

Sarah Nelson

Understanding American Indian Youth in Residential Recovery from Substance Use Disorder: Risk and Protective Experiences and Perceived Recovery Support

理解美国印第安青年在物质使用障碍康复中的经历：风险与保护因素及感知到的康复支持

This article discusses a community-based participatory research project with university researchers, an urban inter-tribal center, and other community partners to develop, administer, and deliver a community needs assessment of an urban American Indian (AI) community. In the development process, community focus groups identified major domains of inquiry for a needs assessment survey: mental health and substance abuse, medical care, and social services, including cultural programming. Results are presented and discussed in each domain. Overall, this community needs assessment contributes to a better understanding of American Indian and Alaska Native (AI/AN) urban challenges by providing information about the AI/AN population in a large southwest metropolitan area. Specifically, it highlights the relevance of local and state contexts for understanding issues facing AI/AN populations. A growing body of research indicates that AI/AN populations demonstrate some similar challenges in terms of health, social service needs, and mental health and substance abuse needs due to shared histories of colonization and misguided or underfunded government programs, among other factors. It remains true that AI/AN communities nonetheless are each distinctive and face unique challenges and opportunities within the local, state, and regional contexts in which they reside. The process described in this paper will inform policy, practice, and research communities interested in understanding the unique realities of an urban community representing many different AI tribes.

Paul Conrad

Maria Scannapieco

Assessing the Needs of Urban American Indians in North Texas: A Community-Based Participatory Research Project

评估北德克萨斯州城市美洲印第安人的需求：一项基于社区的参与式研究项目

While ethnic racial identity (ERI) development is associated with a variety of psychological well-being outcomes, the mechanisms through which this association operates is yet to be fully explained. During adolescence, social belonging is a developmentally salient process that can play a key role in how ERI impacts well-being. We sought to explore the mediating role of belonging to peer networks in the association between ERI and self-esteem among Native American adolescents. In this cross-sectional, mediational study, we used survey data from 317 Native American students attending a reservation high school (46.9% female; M age =16). Students' levels of ERI development were measured by combining items from two scales pertaining to ethnic identity development and racial identity. We employed a structural equation modeling approach to explore the mediating role of peer belonging in the association between ERI and self-esteem. Results suggest that our 4-item index of peer belonging was an acceptable measure of this construct. Further, the significant indirect effect of peer belonging explains a notable portion (β=.22, p ≤ .05) of the total effects of ERI on self- esteem (β=.54, p ≤ .05). This finding suggests that higher levels of ERI achievement contribute to higher levels of peer belongingness, which in turn lead to improved self-esteem among students. Implications for research and practice are discussed.

Zainab Hosseini

Teresa LaFromboise

Ethnic Racial Identity Development and Self-Esteem among Native American Adolescents: The Mediating Role of Peer Belonging

土著美国青少年族裔身份发展与自尊：同伴归属的中介作用

This study aimed to determine the prevalence of breastfeeding initiation and continuation at two months postpartum in American Indian (AI) mothers in South Dakota and to identify factors associated with breastfeeding. Using logistic regression, data from the South Dakota Pregnancy Risk Assessment Monitoring System were used to investigate the relationship between binary breastfeeding initiation and continuation outcomes and maternal behaviors and experiences including access to health care, safe sleep practices, ability to handle life events, depression, and sources of breastfeeding information. Higher odds of initiation were seen for factors including access to health care services, ability to handle life events, and sources of breastfeeding information, while lower odds were seen for factors including safe sleep. Higher odds of continuation were seen among mothers who reported not taking long to get over setbacks and among mothers who reported no postpartum depression, while lower odds of continuation were seen among mothers practicing safe sleep. Several modifiable factors were identified as reasons for stopping breastfeeding. This information about factors associated with higher odds of breastfeeding initiation and continuation at two months postpartum can be used to inform interventions, programs, and policies designed to support breastfeeding among AI women and to guide future research in this area.

Addison Reimer

Bonny L. Specker

Christine W. Hockett

Katelyn Strasser

Linda Ahrendt

Lacey A. McCormack

Factors Associated with Breastfeeding Initiation and Continuation at Two Months Postpartum in American Indian Women: An Exploratory Analysis

美国印第安妇女产后两个月内母乳喂养启动及持续的相关因素：一项探索性分析

American Indian and Alaska Native (AI/AN) youth use alcohol and drugs at a higher rate with earlier onset than the overall youth population in the United States. Youth interventions are needed to support the prevention and reduction of substance misuse-related issues. Connecting AI/AN children to their heritage through culturally grounded prevention programs has been shown to be more effective than programs designed for the general population. The objective of this formative evaluation was to provide community-informed updates for an existing culturally grounded substance use prevention program, The Beauty Way. This study was conducted in partnership with an AI/AN-serving community organization using key informant interviews and talking circles with community members and parents. Participants revealed the challenges and obstacles AI/AN youth face, the impact of cultural values, and activities which engage youth to prevent problematic substance use. Recommendations include the importance of 1) incorporating current challenges to behavioral health such as social media and vaping, 2) including cultural values and activities including land-based learning, and 3) creating a robust facilitator guide and hiring culturally sensitive program staff. These results generated recommendations to strengthen the cultural focus and application of The Beauty Way for AI/AN youth.

Amanda M. Hunter

Sheena Greenstone

Kyanna McCafferty

Heather J. Williamson

Recommendations for Modernizing a Culturally Grounded Substance Use Prevention Program for American Indian and Alaska Native Youth

针对美国印第安和阿拉斯加原住民青少年的文化基础性物质使用预防计划的现代化建议

The primary purpose of this study was to 1) explore the relationship among the following variables: thoughts and feelings associated with historical loss, levels of acculturation, alcohol expectancies, and alcohol use among American Indian and Alaska Native (AI/AN) people, as well as to 2) explore predictive relationships among historical loss thoughts and feelings, alcohol expectancies, and alcohol use for AI/AN people within this sample. A convenience (community, non-clinical) sample of 188 AI/AN people completed an online survey, including questions related to alcohol use, alcohol expectancies, thoughts and feelings of historical loss, and acculturation experiences. Results indicated that gender and feelings of historical loss were the significant individual predictors of alcohol use and alcohol expectancies in a sample of AI/AN people. In addition, specific types of alcohol expectancies, when considered together, explained 24% of the variance in alcohol use experiences. Gender differences were noted in that AI/AN men were more likely than AI/AN women to engage in hazardous drinking and expected more feelings of social and physical pleasure as well as power and aggression as a result of drinking alcohol. Areas for further research were highlighted, with an emphasis on further research exploring the correlates and predictors of alcohol use and alcohol expectancies for community, non-clinical samples of AI/AN people, to further understand alcohol use motivation among AI/AN people.

Melanie J. Cain

The Relationships of Historical Loss, Acculturation, and Alcohol Expectancies with Alcohol Use Among American Indian and Alaska Native People

美国印第安人和阿拉斯加原住民的历史损失、文化适应与酒精预期对酒精使用的影响关系

American Indian and Alaska Native (AI/AN) adolescents face health disparities resulting from historical traumas. There is a paucity of research focusing on mental health in AI/AN adolescents or the relationship between cultural connection and health. This project assesses the relationship between cultural identity and markers of mental health and well-being for AI/AN adolescents. Adolescents 12 to 18 years old from the Lumbee Tribe of North Carolina participated in this mixed-methods study. Phase 1, discussed in this manuscript, involved surveys using validated instruments to assess cultural connection and markers of mental health and well-being. Characteristics of the 122 AI/AN youth who completed the survey included: mean age 14.9 years (SD = 2.0); 61% (n = 75) assigned female at birth; 56% (n = 70) identified as female; and 4.1% (n = 5) identified as non-binary. Mean tribal affiliation (TA) and ethnic identity (EI) scores suggest strong cultural connection (TA: M = 3.1/5, SD = 0.6; EI: M = 3.4/5, SD = 0.9). Sleep quality (M = 2.63/5) and positive stress management (M = 2.06/5) were low. Bivariate and logistic regression demonstrated moderate positive correlations between EI and friendship, EI and emotional support, TA and friendship, and TA and emotional support. AI/AN adolescents in this sample have a moderate-strong connection with Native culture, marked by ethnic identity and tribal affiliation, and positive markers of mental health and well-being. Data from this study may be used for policy formulation to promote increased funding and programming addressing mental health for AI/AN youth.

Abbreviation	AIANMHR
Journal Impact	1.97
Quartiles(Global)	PSYCHOLOGY, CLINICAL(Q3)

ISSN	0893-5394, 1533-7731
h-index	30

Publication Information	Publisher: University Press of Colorado，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1992，Proportion of original research papers: ，Self Citation Rate:， Gold OA Rate:

American Indian and Alaska Native Mental Health Research

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