The health challenge of stress experienced by Native American adolescents.

Little is known about how Native American youth experience or manage stress. The purpose of this study was to describe the health challenge of stress experienced by Cherokee-Keetoowah adolescents and to identify approaches used to manage stress. All adolescents regardless of ethnicity face normative sources of stress, such as daily hassles and transition experiences like moving to a new school. Native American youth are known to have significantly greater stress, related to social and economic factors, than their white peers. They are exposed to a variety of continuous stressors including poverty and family disruption. A qualitative story-theory-guided approach was used to conduct a secondary analysis of existing data collected from a larger study where written stories of stress were gathered from 50 Cherokee-Keetoowah adolescents ranging in ages from 14 to 18 years. The data analysis was guided by the story inquiry method to identify dimensions of the health challenge of stress and approaches used to resolve the health challenge. Three health challenge groups were identified: burden of expectations, relationship disruption, and imposing feelings and the actions of others. The most frequently described stories of stress expressed were the burden of expectation of self or from others (n=33). Connecting with valued others, engaging in meaningful activities, and choosing a positive attitude about change were themes that characterized ways that these adolescents managed stress. It is essential to understand how Native American adolescents experience stress and what they do to manage it if we wish to deter the physical and mental consequences of stress. The development of stress-reducing culturally competent interventions that are built on a foundation such as story sharing is a culturally congruent approach for intervening with Native American adolescents.