Abstract
American Indian and Alaska Native (AIAN) youth are characterized by high rates of pregnancy and risky sexual behavior. Reaching these youth with culturally appropriate interventions is difficult due to geographic dispersion and cultural isolation. Online interventions can provide opportunities for reaching and engaging AIAN youth. However, electronic interventions are also impersonal and this can be culturally incongruous for AIANs and other populations for whom traditional ceremonies, practices and patterns of interpersonal communication are central. This paper describes the application of community based participatory research methods to: (1) identify concerns about the exclusive use of an online sexual health program; (2) address community concerns by developing supplemental class lessons, and (3) evaluate the feasibility and acceptability of the new hybrid intervention. Data derives from qualitative and quantitative sources. During the formative phase of the project, qualitative data from partner interactions was analyzed with participatory inquiry to inform intervention development. To evaluate the intervention, qualitative data (e.g., interviews, surveys) were used to understand and explain quantitative measures such as implementation fidelity and attendance. Implementers were enthusiastic about the hybrid intervention. The lessons were easy to teach and provided opportunities for meaningful discussions, adaptations, and community involvement. The use of online videos was an effective method for providing training. Working with community partners, we resolved cultural concerns arising from the exclusive use of the Internet by creating a hybrid intervention. The additional burden for staff to deliver the class lessons was considered minimal in comparison to the educational and programmatic benefits of the hybrid intervention.
ClinicalTrials.gov identifier NCT01698073.
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Acknowledgements
This publication was made possible by Grant Number TP2AH000003 (Kaufman, PI) from the Office of Adolescent Health. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Office of Adolescent Health, the Office of the Assistant Secretary for Health, or the Department of Health and Human Services.
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All authors have complied with the Principles of the Ethical Practice of Public Health. This study was approved by the University of Colorado IRB and appropriate entities for each tribal community.
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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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Informed consent was obtained from all individual participants included in the study.
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Black, K.J., Morse, B., Tuitt, N. et al. Beyond Content: Cultural Perspectives on Using the Internet to Deliver a Sexual Health Intervention to American Indian Youth. J Primary Prevent 39, 59–70 (2018). https://doi.org/10.1007/s10935-017-0497-0
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DOI: https://doi.org/10.1007/s10935-017-0497-0