Award Date

December 2015

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

First Committee Member

Michelle Chino

Second Committee Member

Melva Thompson-Robinson

Third Committee Member

Carolee Dodge-Francis

Fourth Committee Member

Daniel Benyshek

Number of Pages

371

Abstract

Introduction: Native American youth are at disproportionate risk for HIV infection. Native Americans represent about 1.7% of the U.S. population, yet they rank fifth in HIV/AIDS diagnosis nationwide (U.S. Census, 2012; CDCd 2013). Native Americans with HIV/AIDS are more likely to be younger than non-Native Americans with the disease. There are limited evidence-based HIV/AIDS and teen pregnancy prevention interventions that have been developed, adapted, and/or evaluated for Native American teens. The purpose of this study was to adapt an existing evidence-based HIV/AIDS and teen pregnancy prevention intervention into a culturally responsive intervention curriculum for Native teens. Methods: There were three phases in this study: 1) Adaptation; 2) Implementation; and 3) Evaluation. The first phase of this study was to adapt the evidenced-based Becoming A Responsible Teen intervention with the assistance of a national advisory board. The recommendations were collected and compiled. The second phase of this study was implementing a pilot of the adapted curriculum for Native American teens aged 14-18 living within the Las Vegas, Nevada metropolitan area. The final phase involved a multi-level evaluation using mixed-methods approach: 1) a quantitative, pre-post, HIV knowledge survey; 2) end-of-session surveys that allowed for both quantitative and qualitative feedback on curriculum content and activities; 3) an end-of-intervention survey that gathered quantitative and qualitative feedback on the overall curriculum content and activities; and 4) a focus group to collect qualitative data about curriculum content and activities. Results: Based on the recommendations from the national advisory board tribal social structures, tribal stories, cultural teachings/philosophy, history, and tribal data were strategically incorporated into the curriculum. The adapted curriculum was pilot tested with 14 participants who all completed the intervention. There was significant difference in the pre-survey (M=13.93, SD=3.08) and post-survey (M=17.14, SD=2.25), indicating that participant HIV knowledge scores, increased on average by 3 points. The majority of the end-of-sessions and end-of-intervention survey Likert-scale responses among, all categories were rated good or very good. The focus group results indicated the adaptations helped participants to understand the link of cultural teachings to responsible-decision making. Conclusion: The findings support the premise that with a few carefully constructed, culturally appropriate adaptations, the adapted BART can be an appropriate HIV/AIDS intervention for Native American teens.

Keywords

Adapting; Culturally Responsive; Evidence-based interventions; HIV/AIDS; Indigenous; Native American

Disciplines

Public Health Education and Promotion

File Format

pdf

Degree Grantor

University of Nevada, Las Vegas

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

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