Development of a Culturally Informed Child Safety Curriculum for American Indian Families
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American Indian (AI) children are disproportionately affected by unintentional injuries, with injury mortality rates approximately 2.3 times higher than the combined rates for all children in the United States. Although multiple risk factors are known to contribute to these increased rates, a comprehensive, culturally informed curriculum that emphasizes child safety is lacking for this population. In response to this need, academic and tribal researchers, tribal community members, tribal wellness staff, and national child safety experts collaborated to develop a novel child safety curriculum. This paper describes its development and community delivery. We developed the safety curriculum as part of a larger randomized controlled trial known as Healthy Children, Strong Families 2 (HCSF2), a family-based intervention targeting obesity prevention in early childhood (2–5 years). During the development of the HCSF2 intervention, participating tribal communities expressed concern about randomizing enrolled families to a control group who would not receive an intervention. To address this concern and the significant disparities in injuries and unintentional death rates among AI children, we added an active control group (Safety Journey) that would utilize our safety curriculum. Satisfaction surveys administered at the 12-month time point of the intervention indicate 94% of participants (N = 196) were either satisfied or very satisfied with the child safety curriculum. The majority of participants (69%) reported spending more than 15 min with the curriculum materials each month, and 83% thought the child safety newsletters were either helpful or very helpful in making changes to improve their family’s safety. These findings indicate these child safety materials have been well received by HCSF2 participants. The use of community-engaged approaches to develop this curriculum represents a model that could be adapted for other at-risk populations and serves as an initial step toward the creation of a multi-level child safety intervention strategy.
KeywordsChild safety American Indian Unintentional injuries Culturally informed Community-based participatory research (CBPR)
We would like to thank our community partners; Nancy Bill, Injury Prevention Program Manager, Indian Health Service; and the Safe Kids Madison Coalition for their contributions and expert advice in developing the curriculum. We extend special thanks to Alan Tomow, Nathania Tsosie, and the AI families who participated in focus groups at the University of New Mexico to comment on the newsletter development process. We also thank Katie Berns for helping with the survey data analysis. Lastly, we want to thank all tribal wellness staff members, HCSF2 site coordinators, and families participating in the HCSF2 trial for their involvement in, and contribution to, this project.
This study was funded by the National Institutes of Health (NIH) 1 R01 HL114912. Emily Tomayko’s time on this project was supported through NIH 5T32 DK007665 while she was a postdoctoral fellow at the University of Wisconsin.
Compliance With Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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