Abstract
A clear need exists for teen pregnancy prevention programs that are responsive to the specific needs and cultural contexts of Native American communities. Recent data indicates that the birth rate for Native teens is nearly two and a half times the rate for White teens (32.9 versus 13.2). To address this disparity, we conducted formative research with Northern Plains Native American community members, resulting in My Journey, a culturally attuned curriculum for 6–8th graders. My Journey is grounded in traditional values and teachings to promote self-efficacy in sexual health decision-making and engagement in prosocial behaviors. We conducted a pilot study with 6–8th grade students (n = 45), aged 11–14 years (22 females, 23 males). Pilot study findings confirm program feasibility and acceptability. The process evaluation revealed that teachers liked the curriculum, particularly its adaptability of cultural components and ease of student engagement. The outcome evaluation demonstrated that My Journey provided an avenue for NA youth to increase their sex refusal self-efficacy. Application of the culture cube framework revealed My Journey has made a meaningful practice-based evidence contribution as a community-defined, culturally integrated curriculum that is effective. Future directions include broader implementation of My Journey, including adaption for additional populations.
Highlights
The teen birth rate has steadily declined over the past decade, with a decrease of 55% from 2007 (41.5) to 2017 (18.8), a historic low for the United States (U.S.) [1]
The focus of the present study is to describe a pilot study of the My Journey program, including an in-depth process evaluation and a preliminary outcomes evaluation, and analysis of the practice-based evidence using the culture cube framework
The results of our pilot study indicate that, are the facilitators pleased with the curriculum and its application within tribal youth classrooms, but My Journey has a positive effect on the self-efficacy of Native teens
Summary
The teen birth rate (births per 1,000 15-19 year old females) has steadily declined over the past decade, with a decrease of 55% from 2007 (41.5) to 2017 (18.8), a historic low for the United States (U.S.) [1]. The decline is largely attributed to the fact that, more teens are 1) using contraceptives, and are 2) using them more effectively [2], which is likely, at least in part, due to teen pregnancy prevention efforts [2,3]. Decreases in teen birth rates have occurred for all racial and ethnic groups, rates in the U.S remain high among industrialized countries, and racial and ethnic disparities. 2: The Medicine Wheel as a Guiding Symbol. I can describe how the medicine wheel will be used in My Journey. Overview My Journey: Yesterday, today, tomorrow as concepts I can identify and define the four quadrants of the balanced person model
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