The development and testing of a multi-level, multi-component pilot intervention to reduce sexual and reproductive health disparities in a tribal community

ABSTRACT

This manuscript presents the results from a multi- level, multi-component pilot intervention designed to reduce sexual and reproductive health (SRH) among American Indian (AI) youth living on a reservation in the Northwestern United States. Our theoretical framework included community based participatory research (CBPR) and Ecological Systems Theory (EST). The pilot intervention was a school-based curriculum for youth and parents and a cultural mentoring program. Mixed methods were used including a pre/post test design and focus groups. Quantitative data was analyzed using McNemar’s chi-square and a random effects model. Qualitative data was analyzed with grounded theory and content analysis. Parents reported increased communication about SRH topics with their children. Youth reported increased condom use self-efficacy, increased condom use, and positive agreement with attitudes toward pregnancy. Our results also suggest increased communication about SRH topics in parent dyads and the need for increased communication with elders. Future research is needed to test the efficacy of multi-level, multi-component tribally driven SRH interventions for AI youth and their families that integrate contemporary SRH issues with traditional values and beliefs.

KEYWORDS:

• Community based participatory research
• pilot intervention
• sexual and reproductive health
• tribal communities

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Acknowledgments

The tribally based research team and the university based research team would like to thank the school administrators, teachers, youth and parents who participated in the pilot intervention, the elders who worked with us on the pilot intervention as well as the members of our study’s community advisory board. Their respective participation was central to the important knowledge gained from our pilot intervention.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Center for American Indian and Rural Health Equity (CAIRHE) at Montana State University through the National Institute of General Medical Sciences Award Number : P20GM104417.