Are American Indian/Alaska Native Adolescent Health Behaviors Different? A Review of AI/AN Youth Involved in Native STAND Curriculum, 2014\u20132017 United States

Megan Skye,Allyson Kelley,Brittany Morgan,Michelle Singer,Kavita Rajani,Stephanie Craig,Tosha Zaback,Caitlin Donald,William Lambert

doi:10.1007/s10995-021-03256-7

Abstract

ObjectivesTo explore health behavior profiles of AI/AN youth involved in native students together against negative decisions (STAND), a national culture-based curriculum.MethodsWe analyzed data from 1236 surveys conducted among AI/AN youth at 40 native STAND implementation sites located in 16 states throughout the US from 2014 to 2017. Health profiles included demographics, sexual orientation, sexual activity, STI testing, cigarette use, and suicide attempts in the past 12-months. We used t-tests and chi square tests of independence to compare risk behavior prevalence among the sample.ResultsHealth behavior profiles of AI/AN youth indicate that 45.6% of youth did not use condoms the last time they had sex, and 82.7% have never been tested for STIs. Differences in cigarette smoking were observed in questioning youth (questioning: 80.3%, straight/heterosexual: 63.8%, LGBTQ2S + : 49.9%, p = 0.03).Conclusions for PracticeHealth behaviors related to sex, substance, violence and self-harm, are at least as common for AI/AN youth as those observed in other US teens. Future research should consider similarities and differences in health profiles of AI/AN youth when designing interventions that affect them. Further, our findings underscore the need for culturally-relevant curricula like native STAND, not because their health behavior is different, but because their socio-ecologic environment is different.

Highlights

During adolescence, risky health behaviors, such as early sexual debut or alcohol and drug misuse, are associated with negative outcomes that track into adulthood (McCabe et al, 2016; Spriggs & Halpern, 2008a); Springs & Halpern, 2008b
The Native students together against negative decisions (STAND) baseline data confirms that health behaviors related to sex, substance misuse, violence, and self-harm, are at least as common for American Indian (AI)/AN youth as for other US teens
Our sample closely followed trends observed in the 2017 Youth Risk Behavioral Study (YRBS) in relation to condom use and sexually transmitted infection (STI) testing, with more boys than girls reporting using condoms and more girls than boys reporting being tested for STIs

Summary

Introduction

Risky health behaviors, such as early sexual debut or alcohol and drug misuse, are associated with negative outcomes that track into adulthood (McCabe et al, 2016; Spriggs & Halpern, 2008a); Springs & Halpern, 2008b. Education (BIE) schools (Beauvais et al, 2008; Blum et al, 1992; Borowsky et al, 1999; Whitesell et al, 2007). The results from these studies have provided valuable insights into the prevalence of AI/AN youth’s behavioral health. A 2015 report published by the Indian Health Service (IHS) found that AI/AN adolescent and young adult suicide rates are up to six times greater than non-AI/AN populations (US Department of Health and Human Services [USDHHS], 2017). National data from the Youth Risk Behavioral Study (YRBS) from 2007–2009 found that AI/ AN youth had higher odds of engaging in sexual risk-related health behaviors than their white peers (USDHHS, 2020)

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