Limited research has examined how ethnic identity and sense of community may be associated with psychological well-being in American Indian adolescents. Via survey data, we examined the relationships among ethnic identity, sense of community, psychosomatic symptoms, positive affect, and feelings of depression with students from a tribal high school (N 5 95; n 5 37 males; n 5 58 females; aged 14.4-20.95 years; mean 5 17.3, SD 5 1.47 years). A majority of the sample self-identified as American Indian/Native American (85.3%), with small percentages reporting additional ethnic backgrounds. Analyses revealed a significant difference in sense of community and positive affect by ethnic identity group. Post hoc analyses demonstrated adolescents in the ''achieved'' identity group were significantly higher on sense of community and positive affect than the other three groups. However, there were no significant differences on feelings of depression or psychosomatic symptoms by ethnic identity group. Implications for interventions are discussed. C 2010 Wiley Periodicals, Inc.A history of attacks on American Indian (AI) culture has included the prohibition of traditional language, bans on religious practices, removal and relocation of entire

Using a daily diary design, we examined fluctuations in caregiver well-being; how day-to-day variations in stressors related to the caregiving experience are linked to fluctuations in well-being; and whether caregivers who are women, or high on certain personality traits (e.g., neuroticism) are more susceptible to emotional/physical health fluctuations in the face of daily stressors. Sixty-three caregivers reported on eight consecutive days. Multilevel analyses (Hierarchical Linear Modeling) indicated significant within-person reactivity. On days when caregivers faced more tasks than usual, more care recipient behavior problems, or more family disagreements regarding care, they experienced more depressive symptoms, feelings of burden, and physical symptoms. Some within-person patterns of reactivity were moderated by gender and personality. Implications for community interventions for caregivers are discussed.

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Objectives To examine the impact of gender norms on American Indian (AI) adolescents' sexual health behavior. Methods The project collected qualitative data at a reservation site and an urban site through 24 focus groups and 20 key informant interviews. Results The reasons that AI youth choose to abstain or engage in sexual intercourse and utilize contraception vary based on gender ideologies defined by the adolescent's environment. These include social expectations from family and peers, defined roles within relationships, and gender empowerment gaps. Conclusions Gender ideology plays a large role in decisions about contraception and sexual activity for AI adolescents, and it is vital to include re-definitions of gender norms within AI teen pregnancy prevention program.

This study examined aspects of the sociocultural context in which American Indian (AI) teen pregnancy occurs, focusing specifically on protective factors for Northern Plains AI youth. Principles of community-based participatory research guided the qualitative data collection from 185 community members (focus groups with AI youth, youth parents, and elders; interviews with health care providers and school personnel) from a reservation and an urban community. Results indicated three protective systems impacted the sexual health and behaviors of AI youth: school, family, and enculturation. These findings provide a better understanding of how specific protective factors within these systems may buffer AI youth from involvement in risky sexual behaviors and work to inform culturally relevant prevention and intervention efforts.

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The Collaborative Research Center for American Indian Health (CRCAIH) was established in September 2012 as a unifying structure to bring together tribal communities and health researchers across South Dakota, North Dakota and Minnesota to address American Indian/Alaska Native (AI/AN) health disparities. CRCAIH is based on the core values of transdisciplinary research, sustainability and tribal sovereignty. All CRCAIH resources and activities revolve around the central aim of assisting tribes with establishing and advancing their own research infrastructures and agendas, as well as increasing AI/AN health research. CRCAIH is comprised of three divisions (administrative; community engagement and innovation; research projects), three technical cores (culture, science and bioethics; regulatory knowledge; and methodology), six tribal partners and supports numerous multi-year and one-year pilot research projects. Under the ultimate goal of improving health for AI/AN, this paper describes the overarching vision and structure of CRCAIH, highlighting lessons learned in the first three years.

Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program effectiveness, few teen pregnancy prevention programs have published on recommendations for adapting these programs to address the specific needs of Northern Plains American Indian youth. We employed a mixed-methods analysis of 24 focus groups and 20 interviews with a combined total of 185 urban and reservation-based American Indian youth and elders, local health care providers, and local school personnel to detail recommendations for the cultural adaptation, content, and implementation of a teen pregnancy prevention program specific to this population.Gender differences and urban /reservation site differences in the types of recommendations offered and the potential reasons for these differences are discussed. This is an Open Access article. Non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly attributed, cited, and is not altered, transformed, or built upon in any way, is permitted. The moral rights of the named author(s) have been asserted. KEYWORDS American Indian, teen pregnancy prevention, program recommendations 218 Teen Pregnancy Prevention Program Recommendations 219 INTRODUCTIONAlthough adolescents of all races and ethnicities engage in behaviors such as unprotected sex and substance use that increase their risk for sexually transmitted infections (STIs) and teen pregnancies (Eaton et al., 2012), American Indian/Alaska Native (AI/AN) youth experience disproportionately higher rates of teen pregnancy compared with the overall population (de Ravello, Jones, Tulloch, Taylor, & Doshi, 2014). Furthermore, while the birth rate for U.S. teens aged 15-19 has dropped in 18 of the past 20 years, changes in the annual birth rates for AI/AN teens have been less consistent over the past two decades and have remained notably higher than those of non-Hispanic Whites and Asian/Pacific Islanders (Solomon-Fears, 2013). For example, in 2012, the birth rates for AI/AN teens was 34.9 per 1,000 live births while the national rate reached a historic low of 29.4 and the rate for non-Hispanic White teens was lower yet at 20.5 (Martin, Hamilton, Osterman, Curtin, & Mathew, 2013). AMERICAN INDIAN/ALASKA NATIVE SEXUAL RISK BEHAVIORSPrevious findings regarding adolescent sexual behavior also reveal that a greater proportion of urban AI/AN youth engage in sex at younger ages and are less often using any method of contraception compared to the overall population (de Ravello et al., 2014). Specifically, in a study examining the reproductive health and behaviors of urban AI/AN girls through data gathered from the 2002 National Survey of Family Growth (Rutman, Taualii, Ned, & Tetrick, 2012), findings revealed that approximately 33% of urban AI/...