Elizabeth Rink

Montana State University, Bozeman, MT, United States

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Publications (10)14.5 Total impact

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    ABSTRACT: The purpose of this study was to implement a sexual health behavioral intervention in Greenland in order to reduce sexually transmitted disease rates among a population of Greenland youth. This behavioral intervention was called Inuulluataarneq (Having the Good Life). Inuulluataarneq's objects included: (1) increase Greenlandic youth's overall knowledge about sexually transmitted diseases and sexual health; (2) increase parent/guardian-youth communication about topics related to sexually transmitted diseases and sex; and (3) increase consistent condom use among Greenlandic youth. We hypothesised that increased awareness of sexually transmitted diseases and sexual health as well as increased communication between parents/guardians and their adolescent children would influence sexual risk behavior and reduce sexually transmitted diseases among our sample population, with a focus on urine samples of chlamydia infection. Results indicate that the influence of having a parent/guardian to speak with about topics related to sex, including the consequences of pregnancy, are key protective factors in reducing sexually transmitted diseases among Greenlandic youth. Inuulluataarneq demonstrates that intensive short-term education and skill-building delivered by a trained community member is an effective sexually transmitted disease prevention intervention method among young Inuit populations who live in small isolated Arctic communities.
    International Journal of STD & AIDS 04/2014; · 1.00 Impact Factor
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    ABSTRACT: Native Americans in the United States are not typically regarded as a most at-risk population for HIV or other sexually transmitted infections (STIs), despite emerging evidence which suggests otherwise. As a result, Native Americans lack access to key prevention services and programs. In planning prevention programs for this unique population, however, it is important to take into account the cultural factors that may be implicated in health risk behaviors. Historical Loss is a type of historical trauma that has been reported in Native Americans, and which may be related to health behaviors. We examined whether Historical Loss was associated with sexual risk behaviors in a sample of 120 American Indian men living in Fort Peck Reservation in northeastern Montana who completed questions regarding Historical Loss and sexual risk behaviors. Symptoms of Historical Loss that reflected Anxiety/Depression and Anger/Avoidance were associated with an increased likelihood of individuals' having sex with multiple concurrent partners. Health interventions that aim to address HIV/STI prevention should take symptoms of Historical Loss into account, as Historical Loss could be a potential factor that will mitigate HIV, STI, and pregnancy prevention efforts in this population.
    Journal of Community Health 04/2013; · 1.28 Impact Factor
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    ABSTRACT: We present the ethical challenges and lessons learned over the course of a four-year community-based participatory research (CBPR) project conducted on sexually transmitted infections (STIs) in Greenland. Specifically discussed is Inuulluataarneq-the "Having the Good Life" study. Inuulluataarneq is an interdisciplinary international, collaborative CBPR study involving the University of Toronto in Canada, the Greenlandic Medical Research Council, the Centre for Primary Care in Nuuk, the University of Greenland, local health partners and communities in Greenland, the Statens Serum Institut in Denmark, and Montana State University in the United States. Inuulluataarneq is the first CBPR project implemented in Greenland. Ethical issues discussed are: (1) the complexity of working with multiple institutional review boards on an international health research project using a CBPR framework; (2) unexpected influences on health policy; and (3) the dynamic of balancing community decision making and practices with academic research requirements and expectations. Inuulluataarneq's primary contribution to understanding ethical issues when conducting research in the Arctic involves an acceptance of the time, patience, and dedication of researchers and community partners it takes to discuss, understand, and process differing ethical viewpoints and procedures.
    Journal of Empirical Research on Human Research Ethics 04/2013; 8(2):110-8. · 1.49 Impact Factor
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    ABSTRACT: This study examines the extent to which age, fatherhood, relationship status, self-control of birth control method, and the use of birth control influence young Native American men's intention to use family planning services. Data were collected for this study during in-depth interviews with 112 Native American men between the ages of 18 and 24 years. The mean age reported was 21. Thirty-eight percent of the young men reported having children. Almost 70% of the young men reported being in a steady relationship. Eighty-eight percent reported that it was very important that they have self-control of the type of birth control that they use. In addition, 88% of the young men reported that they would use some type of birth control within the next year to prevent a pregnancy with their partner. Logistic regression analysis indicated that as age increased, young men were less likely to seek family planning services for birth control. The young men who reported being fathers were more likely than the young men who did not report being fathers to seek family planning services for birth control. Findings from this study suggest that public health efforts to educate Native American men about family planning services are most effective in their adolescence, before they transition into young adulthood. Fatherhood may also be considered a protective factor that may increase the likelihood that young Native American men will seek family planning services for birth control. Public health efforts that address reproductive health among young Native American men may be effective with Native American men in adolescence, prior to their transition to young adulthood. Family planning services that provide outreach education and care to Native American fathers may also be effective.
    American journal of men's health 03/2012; 6(4):324-30. · 1.15 Impact Factor
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    ABSTRACT: The Fort Peck Sexual Health Project: A Contextual Analysis of Native American Men is a community-based participatory research (CBPR) project that explores the extent to which knowledge, attitudes, and beliefs about sex, intimate relationships, and mental health influence sexual and reproductive health. For the purpose of this study, the influence of age, fatherhood, and mental health factors related to historical trauma and loss on young American Indian (AI) men's intention to use birth control was examined. In-depth interviews were conducted with 112 Native American men between the ages of 18 and 24 years. The mean age reported was 21 years. Thirty-eight percent of the young men reported having children. The young men reported experiences of historical trauma during their lifetime as well as emotional responses due to historical losses. Ninety-five percent reported that it was very important that they use some form of birth control to prevent their partner from getting pregnant within the next year. Logistic regression analysis indicated that, as age increased, young men were less likely to use birth control to prevent pregnancy. The young men who reported feelings of loss due to experiences related to historical trauma and loss were more likely to use birth control. Findings from this study suggest that public health efforts to educate AI men about planned pregnancies and the use of birth control may be most effective in adolescence. Public health programs that address mental health concerns such as the emotional responses due to historical losses may assist young AI men in their decision to use birth control.
    American Indian and Alaska native mental health research (Online) 01/2012; 19(1):57-75.
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    ABSTRACT: Greenland reports the highest rates of chlamydial infection and gonorrhea in the Arctic. Our objective was to determine the presence, and describe the basic epidemiology, of Mycoplasma genitalium for Greenland. Cross-sectional study. 314 residents from Nuuk and Sisimiut, between the ages of 15 and 65 years, participated in "Inuulluataarneq" (the Greenland Sexual Health Project) between July 2008 and November 2009. Participants provided self-collected samples for sexually transmitted infection (STI) testing and completed a sexual health survey. Descriptive statistics and logistic regression were used to summarize the basic characteristics of STI cases overall and M. genitalium and Chlamydia trachomatis specifically. Clinically relevant characteristics in each full model were gender (male or female), age (in years), age at sexual debut (in years), number of sexual partners in the past 3 months (continuous) and history of forced sex and community. The overall prevalence of STIs was 19.0%, specifically: 9.8% for M. genitalium and 9.4% for C. trachomatis; 100% of M. genitalium-positive cases carried macrolide resistance determinants. Being female [OR = 3.2; 95% confidence interval (CI): 1.1-9.8] and younger age (OR = 0.9; 95% CI: 0.9-1.0) were associated with M. genitalium positivity. Age was also associated with C. trachomatis (OR = 0.9; 95% CI: 0.8-0.9) and STI positivity overall (OR = 0.9; 95% CI: 0.9-0.9). We observed a high prevalence of M. genitalium and macrolide resistance in this study. A better understanding of M. genitalium sequelae is needed to inform policy around testing, treatment, control and antibiotic use.
    International journal of circumpolar health. 01/2012; 71:1-8.
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    ABSTRACT: This case study of community and university research partnerships utilizes previously developed principles for conducting research in the context of Native American communities to consider how partners understand and apply the principles in developing community-based participatory research partnerships to reduce health disparities. The 7 partnership projects are coordinated through a National Institutes of Health-funded center and involve a variety of tribal members, including both health care professionals and lay persons and native and nonnative university researchers. This article provides detailed examples of how these principles are applied to the projects and discusses the overarching and interrelated emergent themes of sharing power and building trust.
    Family & community health 01/2011; 34(3):246-55. · 0.99 Impact Factor
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    ABSTRACT: To develop a culturally competent and socially relevant sexual health survey for people living in Nuuk, Greenland, aged 15 years and older. Qualitative study with interviews. Community and research informants (n=10) were interviewed informally to identify survey topics. A sexual health survey was constructed combining local knowledge from informants with a review of sexual health literature for the Arctic and other Indigenous locations. The draft survey was distributed to community partners for commentary and revision. After translation into Danish and Greenlandic, cognitive interviews were conducted with 11 Nuuk residents, identified through snowball sampling, to both pilot test the survey and exchange social and cultural knowledge relevant to sexual health in Nuuk. The utility of this process was evaluated against implementation of the final survey to Nuuk residents enrolled in Inuulluataarneq (n=149). Theme saturation was reached by the ninth interview. STI risk and self-efficacy, co-occurrence of alcohol use and sex and STI knowledge were identified as most relevant. Questions about community efficacy, culture/community involvement and identity were most sensitive. Upon implementation of the final survey, 146 of 149 participants answered all survey questions. Two Elder participants refused to answer questions about sex. Some questions had low response variability but still added to our contextual understanding and helped to build rapport with participants. Combining an iterative process with community-based participatory research principles and cognitive interview techniques was an effective method for developing a sexual health survey with Nuuk residents.
    International journal of circumpolar health 02/2010; 69(1):25-37. · 1.30 Impact Factor
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    ABSTRACT: Increasingly, community-based participatory research (CBPR), with its emphasis on engaging communities as full and equal partners in all phases of the research process is being promoted to address the health needs of peoples living in the North American Arctic. However, the CBPR approach is not without its challenges in Arctic countries such as Greenland, where research capacity, different languages, distance, time and cost become barriers to remaining true to the purest form of CBPR. In this paper, we describe the practical application of CBPR principles and methodologies to a sexual health project investigating sexually transmitted infections in Greenland. We present the initial challenges encountered in the early stages of the pilot CBPR sexual health study, and solutions to these challenges. We also provide recommendations for expanding the capacity in Greenland to conduct CBPR projects.
    International journal of circumpolar health 09/2009; 68(4):405-13. · 1.30 Impact Factor
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    ABSTRACT: Our objective was to describe the basic epidemiology of sexually transmitted infections for Arctic and sub-Arctic regions of North America. We summarized published and unpublished rates of chlamydial infection and gonorrhea reported from 2003 through 2006 for Alaska, Canada, and Greenland. In 2006, Alaska reported high rates of chlamydial infection (715 cases/100,000 population) compared with the United States as a whole; northern Canada reported high rates of chlamydial infection (1,693 cases/100,000) and gonorrhea (247 cases/100,000) compared with southern Canada; and Greenland consistently reported the highest rates of chlamydial infection (5,543 cases/100,000) and gonorrhea (1,738 cases/100,000) in the Arctic. Rates were high for both men and women, although the highest incidence of infection was predominantly reported for young women in their early twenties. We propose that community-based participatory research is an appropriate approach to improve sexual health in Arctic communities.
    Emerging infectious diseases 02/2008; 14(1):4-9. · 5.99 Impact Factor