Investments in early decision-making about sexual risk-taking often have lifetime benefits and may be especially important for youth of minority groups. American Indian (AI) youth have almost twice the rate of chlamydia found in the national population, even at the youngest ages (10-14), and represent 21% of all AI AIDS cases. The low but rising numbers of AIDS/HIV cases in combination with high rates of STDs support the pressing need for effective prevention in these communities. Meaningful evaluation of HIV/STD prevention efforts aimed at youth, however, is often absent, and the results of those with rigorous designs have been ambiguous. In part, the uncertain findings may be explained by the lack of integration of theoretical frameworks into the analyses of intervention effectiveness: Few have accounted for predisposing factors or developmental trajectories that may diminish the effects of an intervention. In short, youth are likely to respond differently to the same intervention. This project will assess the impact of an HIV prevention intervention curriculum designed explicitly for AI middle-school youth in partnership with 15 middle schools in an AI community. Using Social Cognitive Theory as a framework, we can also account for social context and prior developmental trajectories. Such contextualized interpretation of results is likely to be particularly important in AI reservation communities, many of which endure high levels of morbidity, trauma, and poverty, even while family and cultural life are strong. Furthermore, most prevention programs for youth have focused on urban youth. We know little about how culturally appropriate interventions might work with AI youth in rural settings. The project has four aims: [1] To assess the impact of the intervention on sexual-risk knowledge, expectancies, and behaviors (KEBs) among a sample of AI youth; [2] to determine the impact of the intervention on developmental trajectories of sexual risk and KEBs in this sample of youth, and the effect of varying exposure levels of the intervention on those trajectories; [3] to develop theoretically salient groupings of youth based on initial risk status, family and community context, and risk patterns over time, and to determine the extent to which the impact of the intervention varies by group; and [4] to develop a """"""""best practices"""""""" model of sexual risk intervention for AI youth in consultative feedback sessions with educators, community members, and youth. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH069086-04
Application #
7269877
Study Section
Behavioral and Social Science Approaches to Preventing HIV/AIDS Study Section (BSPH)
Program Officer
Kamath, Susannah M Allison
Project Start
2004-09-21
Project End
2009-07-31
Budget Start
2007-08-01
Budget End
2008-07-31
Support Year
4
Fiscal Year
2007
Total Cost
$538,939
Indirect Cost
Name
University of Colorado Denver
Department
Psychiatry
Type
Schools of Medicine
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Asdigian, Nancy L; Whitesell, Nancy Rumbaugh; Keane, Ellen M et al. (2018) Effects of the ""Circle of Life"" HIV-prevention program on marijuana use among American Indian middle school youths: a group randomized trial in a Northern Plains tribe. Am J Drug Alcohol Abuse 44:120-128
Mitchell, Christina M; Kaufman, Carol E; Whitesell, Nancy Rumbaugh et al. (2017) Self-Efficacy About Sexual Risk/Protective Behaviors: Intervention Impact Trajectories Among American Indian Youth. J Res Adolesc 27:697-704
Kaufman, Carol E; Whitesell, Nancy Rumbaugh; Keane, Ellen M et al. (2014) Effectiveness of Circle of Life, an HIV-preventive intervention for American Indian middle school youths: a group randomized trial in a Northern Plains tribe. Am J Public Health 104:e106-12
Whitesell, Nancy Rumbaugh; Asdigian, Nancy L; Kaufman, Carol E et al. (2014) Trajectories of substance use among young American Indian adolescents: patterns and predictors. J Youth Adolesc 43:437-53
Whitesell, Nancy Rumbaugh; Kaufman, Carol E; Keane, Ellen M et al. (2012) Patterns of substance use initiation among young adolescents in a Northern Plains American Indian tribe. Am J Drug Alcohol Abuse 38:383-8
Kaufman, Carol E; Litchfield, Anne; Schupman, Edwin et al. (2012) Circle of Life HIV/AIDS-prevention intervention for American Indian and Alaska Native youth. Am Indian Alsk Native Ment Health Res 19:140-53
Kaufman, Carol E; Mitchell, Christina M; Beals, Janette et al. (2010) Circle of life: rationale, design, and baseline results of an HIV prevention intervention among young American Indian adolescents of the Northern Plains. Prev Sci 11:101-12
Kaufman, Carol E; Shelby, Laura; Mosure, Debra J et al. (2007) Within the hidden epidemic: sexually transmitted diseases and HIV/AIDS among American Indians and Alaska Natives. Sex Transm Dis 34:767-77
Kaufman, Carol E; Desserich, Jennifer; Big Crow, Cecelia K et al. (2007) Culture, context, and sexual risk among Northern Plains American Indian Youth. Soc Sci Med 64:2152-64