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

Language

English


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