Identifying Protective Factors to Promote Health in American Indian and Alaska Native Adolescents: A Literature Review
Exposure to protective factors, conditions that protect against the occurrence of an undesirable outcome or promote the occurrence of a desirable outcome within an adolescent’s environment, can foster healthy adolescent behaviors and reduce adult morbidity and mortality. Yet, little is known about the nature and effect of protective factors on the positive social and health outcomes among American Indian and Alaska Native (AIAN) adolescents. We conducted a review of the literature to identify the protective factors associated with positive health outcomes among AIAN adolescents. We consulted Elsevier Science Direct, ERIC EBSCOhost, PubMed, and the Web of Science databases. A total of 3421 articles were encountered. Excluded publications were those that did not focus on AIAN adolescents (n = 3341), did not identify protective factors (n = 56), were not original research studies (n = 8), or were not written in the English language. We identified nine categories of protective factors positively associated with health and social outcomes, including: current and/or future aspirations, personal wellness, positive self-image, self-efficacy, non-familial connectedness, family connectedness, positive opportunities, positive social norms, and cultural connectedness. Such factors positively influenced adolescent alcohol, tobacco, and substance use; delinquent and violent behavior; emotional health including depression, suicide attempt; resilience; and academic success. Protective factors spanned multiple domains of the socio-ecological model. Strengths-based health promotion efforts that leverage local, innate protective factors and work with AIANs to create environments rich in protective factors are key to improving the health and wellbeing of AIAN adolescents.
KeywordsAmerican Indian Alaska Native Adolescent Protective factors Asset-based
Research reported in this publication was supported by the National Institute on Minority Health And Health Disparities of the National Institutes of Health under Award No. P20MD006872. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Special thanks to Beth Kaeding and to the Center for American Indian Resilience team.
Compliance With Ethical Standards
Conflicts of interest
The authors have no conflicts of interest to report.
Human and Animal Rights
This research did not involve human subjects or animals.
- * References included in the literature review.Google Scholar
- Allen, J., Mohatt, G., Fok, C., Henry, D., & People Awakening Team. (2009). Suicide prevention as a community development process: Understanding circumpolar youth suicide prevention through community level outcomes. International Journal of Circumpolar Health, 68(3), 274–291.CrossRefPubMedPubMedCentralGoogle Scholar
- *Allen, J., Mohatt, G., Rasmus, M., Hazel, K., Thomas, L., & Lindley, S. (2006). The tools to understand: Community as co-researcher on culture-specific protective factors for Alaska Natives. Journal of Prevention and Intervention in the Community, 32(1–2), 41–59. doi: 10.1300/j005v32n01_04.PubMedGoogle Scholar
- American Academy of Pediatrics (AAP). (2003). Caring For Your Teenager. American academy of pediatrics. Retrieved from http://www.healthychildren.org/English/ages-stages/teen/Pages/Stages-of-Adolescence.aspx.
- American Psychological Association (APA). (2002). A reference for professionals: Developing adolescents. United States Department of Health and Human Services. Washington, DC 20002-4242.Google Scholar
- Centers for Disease Control and Prevention (CDC). (2015a). Why schools? Schools: The right place for a healthy start. The centers for disease control and prevention. Retrieved from http://www.cdc.gov/healthyyouth/about/why_schools.htm.
- Centers for Disease Control and Prevention (CDC). (2015b). The social-ecological model: A framework for prevention. The centers for disease control and prevention. Retrieved from http://www.cdc.gov/violenceprevention/overview/social-ecologicalmodel.html.
- Goodkind, J., LaNoue, M., Lee, C., Freeland, L., & Freund, R. (2012). Feasibility, acceptability, and initial finding for a community-based cultural mental health intervention for American Indian youth and their families. Journal of Community Psychology, 40(4), 381–405. doi: 10.1002/jcop.20517.CrossRefPubMedPubMedCentralGoogle Scholar
- Guba, E. G. (1978). Toward a methodology of naturalistic inquiry in educational evaluation. Los Angeles, CA: University of California Center for the Study of Evaluation.Google Scholar
- Lowe, J., Riggs, C., Henson, J., & Leihr, P. (2009). Cherokee self-reliance and word-use in stories of stress. Journal of Cultural Diversity, 16(1), 1–9.Google Scholar
- Patton, M. Q. (2002). Qualitative research & evaluation methods. Thousand Oaks, CA: Sage Publications Inc.Google Scholar
- Teufel-Shone, N., Gamber, M., Watahomigie, H., Siyuja, T., Crozier, L., & Irwin, S. (2014). Using a participatory research approach in a school-based physical activity intervention to prevent diabetes in the Hualapai Indian community, Arizona, 2002–2006. Preventing Chronic Disease, 11(E166), 1–11.Google Scholar
- *Whitbeck, L., Hoyt, D., Stubben, J., & LaFromboise, T. (2001). Traditional culture and academic success among American Indian children in the upper Midwest. Journal of America Indian Education, 40(2), 48–60.Google Scholar
- *Whitesell, N., Asdigian, N., Kaufman, C., Big Crow, C., Shangreau, C., Keane, E., et al. (2014). Trajectories of substance use among young American Indian adolescents: Patterns and predictors. Journal of Adolescent Health, 43, 437–453.Google Scholar
- Whitesell, N., Mitchell, C., Spicer, P., & The Voices of Indian Teens Project Team. (2009). A longitudinal study of self-esteem, cultural identity, and academic success among American Indian adolescents. Cultural Diversity and Ethnic Minority Psychology, 15(1), 38–50. doi: 10.1037/a0013456.CrossRefPubMedPubMedCentralGoogle Scholar
- World Health Organization (WHO) (2015). Adolescent health. World Health Organization. Retrieved from www.who.int.topics/adolescent_health/en/.