Abstract
BackgroundThe inclusion of protective factors (“assets”) are increasingly supported in developing culturally grounded interventions for American Indian (AI) populations. This study sought to explore AI women’s cultural assets, perspectives, and teachings to inform the development of a culturally grounded, intergenerational intervention to prevent substance abuse and teenage pregnancy among AI females.MethodsAdult self-identified AI women (N = 201) who reside on the Navajo Nation completed a cross-sectional survey between May and October 2018. The 21-question survey explored health communication around the transition to womanhood, cultural assets, perceptions of mother–daughter reproductive health communication, and intervention health topics. Univariate descriptive analyses, chi squared, and fisher’s exact tests were conducted.ResultsRespondents ranged in age from 18 to 82 years, with a mean age of 44 ± 15.5 years. Women self-identified as mothers (95; 48%), aunts (59; 30%), older sisters (55; 28%), grandmothers (37; 19%), and/or all of the aforementioned (50; 25%). 66% (N = 95) of women admired their mother/grandmother most during puberty; 29% (N = 58) of women were 10–11 years old when someone first spoke to them about menarche; and 86% (N=172) felt their culture was a source of strength. 70% (N = 139) would have liked to learn more about reproductive health when they were a teenager; 67% (N = 134) felt Diné mothers are able to provide reproductive health education; 51% (N = 101) reported having a rite of passage event, with younger women desiring an event significantly more than older women. Responses also indicate a disruption of cultural practices due to government assimilation policies, as well as the support of male relatives during puberty.ConclusionsResults informed intervention content and delivery, including target age group, expanded caregiver eligibility criteria, lesson delivery structure and format, and protective cultural teachings. Other implications include the development of a complementary fatherhood and/or family-based intervention to prevent Native girls’ substance use and teen pregnancy.
Highlights
The inclusion of protective factors (“assets”) are increasingly supported in developing culturally grounded interventions for American Indian (AI) populations
The impact of substance use is compounded for American Indian and Alaska Native (AIAN) females as studies have shown that early substance use is closely linked to sexual risk taking and teen pregnancy among adolescent girls [1, 13,14,15,16,17]
American Indian (AI) women over the age of 18 years who self-identified as female and resided on the Navajo Nation were the participants in this study
Summary
The inclusion of protective factors (“assets”) are increasingly supported in developing culturally grounded interventions for American Indian (AI) populations. Walls et al found that Southwest AI girls reported significantly more drug offers and difficulty in drug refusal than their male counterparts [24]. This is concerning because studies indicate teenage girls are at higher risk for substance dependence [25]. Such findings elucidate an increasing awareness of AI gender-specific factors that drive highrisk behaviors, including substance use [8, 12, 26, 27]. Boys more often report they use substances for sensation-seeking while girls use substances to boost their confidence, cope with stress, or control their weight [28]
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