Black Kirsten J, Morse Bradley, Tuitt Nicole, Big Crow CeCe, Shangreau Carly, Kaufman Carol E
Centers for American Indian and Alaska Native Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA.
Butler Institute for Families, University of Denver, Denver, CO, USA.
J Prim Prev. 2018 Feb;39(1):59-70. doi: 10.1007/s10935-017-0497-0.
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.
美国印第安人和阿拉斯加原住民（AIAN）青年的特点是怀孕率高和性行为风险大。由于地理分布分散和文化隔离，通过符合文化特点的干预措施接触这些青年很困难。在线干预措施可为接触和吸引AIAN青年提供机会。然而，电子干预措施也缺乏人情味，这对于以传统仪式、习俗和人际沟通模式为核心的AIAN及其他人群来说，可能在文化上是不协调的。本文描述了基于社区的参与性研究方法的应用，以：（1）确定对仅使用在线性健康项目的担忧；（2）通过开发补充课堂教学内容来解决社区担忧；以及（3）评估新的混合干预措施的可行性和可接受性。数据来源于定性和定量来源。在项目的形成阶段，通过参与性探究分析了来自合作伙伴互动的定性数据，以为干预措施的开发提供信息。为了评估干预措施，使用定性数据（如访谈、调查）来理解和解释诸如实施保真度和出勤率等定量指标。实施者对混合干预措施充满热情。这些课程易于教授，并为有意义的讨论、调整和社区参与提供了机会。使用在线视频是提供培训的有效方法。通过与社区合作伙伴合作，我们通过创建混合干预措施解决了因仅使用互联网而产生的文化担忧。与混合干预措施的教育和项目效益相比，工作人员提供课堂教学内容的额外负担被认为是最小的。ClinicalTrials.gov标识符：NCT01698073。
