Figure 4 - uploaded by Charles R. Figley
Content may be subject to copyright.
Source publication
In comparison with the general population, research indicates a need for greater health equity among American Indian and Alaska Natives (AI/AN). AI/ANs have demonstrated remarkable resilience in response to centuries of historical oppression, yet growing evidence documents mental health disparities. Consequently, some AI/AN youth, defined as 18 yea...
Context in source publication
Context 1
... second and third most supported risk factors were within the community level and included peer influence and school environment. Among the total number of risk and protective factors reported to be relevant within studies, 7% were at the societal level, 16% were at the cultural level, 23% were at the community level, 41% were at the family level, and 13% were at the individual level (See Figure 4). Taken as a whole, 59% of factors had to do with relationships. ...
Citations
... Tribal Elder perspectives highlighted the role of poverty in exacerbating youth risk for suicide, depression, and substance abuse, which reflect risks reported in other studies of AI youth (Ersan & Rodriguez, 2021, Gone & Trimble, 2012Leavitt et al., 2018;McMahon et al., 2013). Risks identified in this study were undergirded by a community context of extreme poverty, a factor known to exacerbate youth risk factors (Burnette & Figley, 2016). Notably, the study findings reveal that youth have few educational and enrichment opportunities outside the programmes and services available through the established OST organization. ...
... Within this context of youth self-harm, Tribal Elders underscored that a youth curriculum needed to include suicide prevention and awareness activities; therefore, a specific focus on suicide prevention was another identified strength of the AILSC. Suicide is a prominent risk factor for AI youth (Burnette & Figley, 2016), and Pham et al. (2022) noted that a defining characteristic of the AILSC was the inclusion of interactive scenarios placing AI youth into challenging life situations including those that could lead to self-harm. In this way, the AILSC emphasizes skill building and an opportunity to learn through real-world examples, which are foundational elements of a positive youth development approach (Roth & Brooks-Gunn, 2016). ...
This study examined a culturally tailored life skills curriculum for addressing tribal youth needs within a positive youth development programme context. In partnership with a Midwest United States tribe and a community-based out-of-school time (OST) organization, the research team interviewed tribal Elders to understand the potential fit of the curriculum and assess how well the curriculum might align with and support youths’ needs. Tribal Elder perspectives highlighted the role of poverty in exacerbating youth risks and identified the limited educational and enrichment opportunities available to tribal youth. Curriculum strengths identified by the tribal Elders included a focus on encouraging self-esteem, identifying emotions and stress, and skill-building opportunities. Curriculum gaps included the need for a greater emphasis on life planning and social-emotional skill development activities and suicide prevention exercises. Founded on a multi-year trust-based relationship with tribal Elders, this study illuminated the needs and strengths of American Indian youth and necessary resources in supporting youth development.
... American Indian and Alaska Native (AI/AN) children are immersed in communities with rich cultural traditions and strong relational connections. Yet, they also carry the generational effects of historical trauma and poverty, resulting in barriers to healthy development including greater risks in the neighborhood or community environment (e.g., crime, poor housing quality, lack of access to healthy food; Bauer et al., 2012;Burnette and Figley, 2016;Austin et al., 2020;Baldwin et al., 2020). These risks present persistent, daily stressors for families (Schaefer-McDaniel, 2009), and accumulation of these risks predicts detrimental health outcomes (Schaefer-McDaniel, 2009;Carroll-Scott et al., 2013;Muñoz et al., 2020), although less is known about influences on early cognition. ...
... Nevertheless, the term "neighborhood" is used in the present study to maintain consistency with measures in the data and existing literature. There is some literature to suggest that AI/AN families, like others from underserved racial and ethnic groups, face unequal access to high-quality neighborhoods due to systemic injustices such as housing discrimination (Osypuk et al., 2009;Sharkey and Elwert, 2011) and forced relocation from traditional lands (Mmari et al., 2009;Burnette and Figley, 2016). AI/AN communities are also at greater risk for living in areas with high crime (Burnette and Figley, 2016;Baldwin et al., 2020), low access to healthy foods (Bauer et al., 2012), and greater exposure to drugs and other substances (Morrell et al., 2020). ...
... There is some literature to suggest that AI/AN families, like others from underserved racial and ethnic groups, face unequal access to high-quality neighborhoods due to systemic injustices such as housing discrimination (Osypuk et al., 2009;Sharkey and Elwert, 2011) and forced relocation from traditional lands (Mmari et al., 2009;Burnette and Figley, 2016). AI/AN communities are also at greater risk for living in areas with high crime (Burnette and Figley, 2016;Baldwin et al., 2020), low access to healthy foods (Bauer et al., 2012), and greater exposure to drugs and other substances (Morrell et al., 2020). ...
Introduction
American Indian and Alaska Native (AI/AN) children possess numerous cultural assets, yet higher exposures to neighborhood risks (e.g., lack of housing, crime) may present barriers to healthy cognitive development, including executive function (EF). Cultural socialization may promote resilience and support children’s early cognition, but this has not been adequately studied. The present study examined the effects of neighborhood risk and cultural socialization on EF for AI/AN preschool children.
Method
Parents/caregivers of 768 AI/AN preschoolers from the 2015 AI/AN Head Start Family and Community Experiences (FACES) Study rated neighborhood risk via two scales: “Neighborhood Problems” and “Environmental Conditions,” and cultural socialization practices via two scales: cultural activities and tribal language activities. Children’s EF was measured directly using the Pencil Tap Task and the Leiter-R attention subscale.
Results
Families perceived neighborhood risks as relatively low, and overall risk did not predict children’s EF. However, higher average language socialization was significantly related to higher EF, as were two specific language activities (encouraging children to learn their tribal language, making sure children heard their tribal language) and two cultural activities (playing AI/AN games, participating in tribal ceremonies), controlling for neighborhood risk.
Discussion
Findings suggest some aspects of cultural socialization may promote resilience among AI/AN preschoolers by supporting early EF. Mechanisms may include increased spiritual, social, and cultural connections, and practice with EF skills during cultural games. Future research should partner with AI/AN communities to investigate culturally grounded EF interventions and reevaluate measures of neighborhood risk to promote resilience and connectedness for AI/AN children.
... There is limited published outcome research on substance use interventions developed for Indigenous Peoples despite some research suggesting higher frequencies of binge drinking, AUD, and negative alcohol-related consequences among these populations [84]. While non-Indigenous treatment methods have been employed, they have been shown to be less effective and particularly destructive to Indigenous individuals [85][86][87]. Therefore, culturally tailored and culturally derived (i.e., developed with communities via CBPR research methodologies) interventions are necessary and have the potential to increase treatment engagement for community members, which also have potential for sustainability within behavioral health [88,89]. ...
Purpose of Review
The role of alcohol varies considerably among Indigenous Peoples and is the backdrop of persistent stereotypes despite decades of research. This paper provides an updated narrative review on the alcohol literature among Indigenous communities, highlighting recent studies published since 2017.
Recent Findings
We examined published literature involving alcohol use rates, including abstinence; risk and protective factors; treatment; and recovery, as well as future directions for alcohol prevention and intervention efforts with Indigenous communities.
Summary
Evidence-based alcohol use prevention, intervention, and recovery strategies with Indigenous communities are outlined. Recommendations are provided for researchers, health providers, and public policy advocates to address and better understand alcohol use, treatment, prevention, and recovery among Indigenous Peoples. Specific recommendations include using community-based participatory research strategies and harm reduction approaches to prevent and treat alcohol use problems with Indigenous communities. Future research is needed to elucidate mechanisms of resilience and recovery from Alcohol Use Disorder and possible shifts in perceptions of alcohol use for Indigenous Peoples.
... The results of the multivariate regression analysis showed that having strong and very strong religious beliefs was the most important predictor of better sexual and reproductive self-care among adolescent females. Based on different systematic reviews, spirituality has been considered to be a protective factor for different aspects of health (including sexual health) among adolescents and youth (31)(32)(33). In addition, religious leaders can have a role in protective and preventive effects in promoting adolescents' sexual and reproductive health by increasing information-sharing (34). ...
Background: Self-care can include the activities that individuals perform in accordance with their needs to maintain and promote their health. Puberty is the most important change that comes with adolescence, which necessitates adolescents to become aware of their sexual and reproductive health. Objectives: The objective of the present study was to investigate the predictors of adolescent females’ sexual and reproductive self-care status. Methods: This cross-sectional study using random multistage sampling was conducted on adolescent females aged 14 - 19 years in the secondary schools of Karaj, Iran, in 2022. A total of 555 female students voluntarily completed the survey. The survey included the Female Adolescents’ Sexual and Reproductive Self-care Scale (FASRSCS). Pearson’s correlation coefficient and univariable and multivariable linear regression were applied. Results: The mean score of the FASRSCS was 65.42 out of 100 (standard deviation (SD) = 10.27). The highest mean score was acquired on the Perception of Female Adolescents of Premarital Sexual Relationships subscale (85.98 (SD = 14.28)), and the lowest mean score was acquired on the Reproductive and Sexual Health Knowledge subscale (36.97 (SD = 23.58)). The total score on the FASRSCS had the strongest association with the Adolescents and Family Interaction subscale (r = 0.71, P < 0.001), and the weakest association was with the Reproductive and Sexual Health Knowledge subscale (r = 0.38, P < 0.001). Multivariable linear regression analysis showed that having very strong religious beliefs (β = 0.23, P < 0.001), receiving information regarding puberty and menstrual health from peers (β = -0.20, P < 0.001), and cold parent-child relationship (β = -0.19, P < 0.001) were independent significant predictors of good sexual and reproductive self-care among adolescent females. Conclusions: Given the importance of religious beliefs, parent-adolescent relationships, and the sources through which adolescents receive information regarding their sexual and reproductive health self-care, it is necessary to appropriate design interventions, including the aforementioned factors, in order to optimize and promote good sexual and reproductive health among female Iranian adolescents.
... Culturally specific risk and protective factors related to the resilience of AI/AN children have been synthesized in two recent systematic reviews. Burnette and Figley (2016) reviewed 51 articles and organized findings into a social-ecological framework (Bronfenbrenner, 1979). Examples of societal factors discovered were historical oppression and discrimination; cultural factors were ethnic identity, spirituality, and connectedness; community factors included community environment, school environment, peer influence, and social support; family factors were family support, family income, parental mental health, family trauma, and stressful life events; and individual factors included self-esteem, impulsivity, and positive perceptions. ...
... Most research involved children, ages 10-19 years, living in rural or Reservation areas. Hodgson et al. (2022) updated the review of resilience in AI/AN children by Burnette and Figley (2016) ...
Aim
To explore the resilience of children, six to thirteen years old, living on a Northern Plains American Indian Reservation using a situation specific nursing theory.
Background
American Indian and Alaska Native children experience mental health inequities compared to their white peers, including substance use, suicide, depression, and anxiety. Resilience is a strength of children that can be leveraged to improve their mental health.
Design
A parallel convergent mixed methods design.
Methods
A community advisory board culturally adapted resilience instruments. During two weeks in summer 2022, forty‐seven children/caregiver dyads completed surveys about the child's resilience. Descriptive statistics gave the scores of each child's personal, relational, and total resilience. A subset of 20 children participated in a semi‐structured interview.
Results
Children scored high on overall resilience, and higher on the relational subscale than the personal subscale. Caregiver survey scores were not significantly correlated with their child's scores and were higher than the children's scores. Qualitative coding revealed six themes of resilience. Integration of data showed a concordance and expansion of the quantitative data across themes.
Conclusion
The children reported high resilience supported by a strong ecosystem of relationships. Resilience, as explained through children's voices, corroborated with findings from the surveys.
Implications for Nursing
Findings will help nurses across sectors of primary, secondary, and tertiary care create resilience‐enhancing interventions and prevent mental health crises in this community.
Impact Statement
This findings from this study will inform local mental health interventions on the Reservation. The study provides a reproducible design to adapt to other Indigenous communities.
Public Contribution
A community advisory board was a partner in every stage of the study. Children and caregivers participated in data collection.
Contribution to the Wider Clinical Community
This research provides knowledge that will further social justice efforts within nursing to promote health equity across diverse populations.
... While some facets of Native peoples' experiences are shared with other minority groups in the U.S.-such as minority stress (Meyer, 2003), racism, prejudice -others are unique -for example, a history of forced relocation by the United States government (Biolsi, 2005) into regions with little economic development (Davis et al., 2016), the forced removal of Native American children from their families and homes into boarding schools (Trafzer et al., 2006), and the criminalization of Native American spiritual practices in the United States until 1978(Native American Rights Fund, 1979. Together, these factors are thought to impact suicide risk trajectories for Native American youth in a way that might differ from youth of other ethnoracial backgrounds (e.g., Burnette & Figley, 2016;O'Keefe et al., 2022). ...
Objective:
Native American adolescents are disproportionately burdened by suicidality. Here, we examine patterns of reporting of suicide ideation and suicide attempt among Native American youth compared to those from other ethnoracial backgrounds, as this data is important for grounding commonly subscribed to frameworks of suicide risk (e.g., ideation-to-action).
Method:
Data are from the Youth Risk Behavior Surveillance Survey (N = 54,243; grades 9-12; 51.0% female) and Minnesota Student Survey (N = 335,151; grades 8, 9, 11; 50.7% female). Comparing Native American youth to peers from other ethnoracial backgrounds, we examined two suicide reporting patterns: 1) odds of reporting suicide attempt among those who reported ideation and 2) odds of reporting suicide ideation among those who reported an attempt.
Results:
Across both samples, when reporting suicide ideation, youth from other ethnoracial backgrounds were 20-55% less likely than Native American youth to also report attempt. While few consistent differences were observed between Native American youth and those from other racial minority backgrounds in patterns of co-reporting suicide ideation and attempt across samples, White youth were between 37% and 63% less likely than Native American youth to report a suicide attempt without also reporting ideation.
Conclusions:
The increased odds of engaging in a suicide attempt with or without reporting ideation question the generalizability of widely held frameworks of suicide risk to Native American youth and have important implications for suicide risk monitoring. Future research is needed to illuminate how these behaviors unfold over time and the potential mechanisms of risk for engaging in suicide attempts in this disproportionately burdened group.Abbreviations: YRBSS: Youth Risk Behavior Surveillance Survey; MSS: Minnesota Student Survey.
... Research also shows that for students who have relocated to attend university, regularly returning home to maintain connection to culture is effective in counteracting assimilation and accommodation (Waterman, 2012). Such strong cultural identity is protective against a wide variety of mental health issues and promotes resilience (e.g., Alcántara & Gone, 2007;Burnette & Figley, 2016;Oré et al., 2016;Wexler et al., 2016). However, all of these strategies require students to adapt to navigate the oppressions and marginalization they face within university settings rather than asking the systems to change to be less oppressive. ...
Higher education institutions present unique settings in which identities and life paths are distinctively shaped. While at their best universities should serve as empowering settings that support their members to grow and develop, to raise awareness of injustice, and to catalyze change, too often systems of higher education in the United States serve to marginalize Indigenous cultures and promote assimilation to White, Euro-American cultures. Counterspaces offer an important response, spaces developed by and for people experiencing oppression that allow for solidarity-building, social support, healing, resource attainment, skill-building, resistance, counter-storytelling, and ideally, empowerment. The Alaska Native (AN) Cultural Identity Project (CIP) is based at an urban U.S.-based university and was rolled out during the COVID-19 pandemic. Developed from the best available scientific and practice literature, local data from AN students, and traditional wisdom from Elders, CIP incorporated storytelling, experiential learning, connection, exploration, and sharing of identity and cultural strengths with the aim of helping AN students understand who they are and who they are becoming. In all, 44 students, 5 Elders, and 3 additional staff participated in the space. In this paper, we sought to understand how CIP was experienced by these unique members who co-created and engaged in this space through 10 focus groups with 36 of the CIP members. We found that the counterspace promoted a sense of community, served as an empowering setting, and set the stage for empowering actions and ripple effects beyond its impact on individuals.
... Within each of these themes, subsistence activities promoted numerous critical aspects of well-being. First, "living off the land" seemed to be an essential aspect of ethnic identity and a source of ethnic pride, which research finds protective for the well-being and wellness of Indigenous peoples (Burnette & Figley, 2016). Knowledge and health behaviors related to traditional foods have clear health benefits and can instill cultural identity and pride (Bodirsky & Johnson, 2008). ...
This chapter explores the finding from the prior chapter to uncover how protective/promotive factors associated with subsistence living relate to well-being and resilience. Traditional, subsistence living style promotes well-being by (a) fostering fond memories and family bonding through “living off the land” which instilled a sense of pride in being self-sufficient; (b) enabling experiential, intergenerational teaching, and learning by passing down subsistence traditions; and (c) promoting resourcefulness (imbuing Native communities with unique knowledge, skills, work ethic) and offsetting economic marginalization (allowing them to be self-employed and provide for their families even in the context of historical oppression) (Portions of this chapter reprinted from the accepted version of the manuscript originally published in Burnette, C. E., Clark. B., & Rodning, C. B. (2018). “Living off the land”: How subsistence promotes well-being and resilience among Indigenous peoples of the U.S. Southeast. Social Service Review, 92(3), 369–400. https://doi.org/10.1086/699287. Copyright © 2018 by The University of Chicago).
... ECB and EM are known to be linked to poverty, maternal health, and infant mortality (Nour, 2009;Raj, 2010;Udgiri, 2017). Indigenous women may be more vulnerable to ECB and EM and their health impacts due to the ongoing context of historical oppression that has resulted in poverty, limited access to health care, and lower access to education (Burnette & Figley, 2016;Parsons et al., 2015;Raj, 2010;Smith et al., 2018). Due to a context of poverty, Indigenous peoples in the United States are likely to bear a higher burden of ECB and EM. ...
... The FHORT is an appropriate theoretical framework as it was developed through years of research to understand and redress IPV (Burnette & Figley, 2017). The FHORT couples Freire's critical perspective on patriarchal colonization and dehumanization (Freire, 2000) with theories of resilience (Ungar, 2008) to offer a strengths-based approach to interpreting the experiences of Indigenous peoples (Burnette & Figley, 2016. From an ecological perspective, the FHORT attributes wellness (achieving balance across physical, mental, emotional, and spiritual domains) to a balance of intersecting multilevel risk and protective factors (Burnette & Figley, 2017). ...
This chapter provides an in-depth exploration of how relationships among settler colonial forms of historical oppression through patriarchal gender roles, early childbearing, and early marriage pose risks for violence and to women’s physical and psychological health and socioeconomic and educational status. Early childbearing (ECB) was a precursor to early marriage (EM), unequal and overburdened marriages, and intimate partner violence (IPV), and the continued harmful effects of multiple abusive relationships. These experiences should be considered in the context of patriarchal historical oppression that systematically dehumanizes and oppresses Indigenous women, who were once treated with respect and esteem. Decolonization and revisualization of the roles of women and girls to help address the negative outcomes that are associated with early childbearing and early marriage are recommended (portions of this chapter reprinted from the accepted version of the manuscript originally published in McKinley, C. E., & Lilly, J. M. (2021). “Marriage is going to fix it”: Indigenous women’s experiences with early childbearing, early marriage, and intimate partner violence. British Journal of Social Work (Advance online publication). https://doi.org/10.1093/bjsw/bcab193. Copyright © 2021 by C. E. McKinley & J. M. Lilly).
... Instead, it has been suggested that researchers strive to use frameworks that allow for a more accurate and fruitful discussion of risk and resilience pathways among AI/AN communities (Alcántara & Gone, 2007). Therefore, in this review, we use the ecosystemic framework (EF) outlined by Burnette and Figley (2016) to organize our results. The framework situates risk and protection within societal, cultural, community, familial, and individual levels. ...
... This variability presents significant concerns of recall bias and response bias based on question wording. Finally, per the recommendation put forth in our previous companion publication , we used the EF (Burnette & Figley, 2016) as an organizational and theoretical structure for our reporting of the RFs evidenced in the corpus (for study descriptives and results, see Table 2). ...
... Accordingly, in this systematic review, we sought to answer the question, "What do we know comprehensively about statistically analyzed RFs for suicide attempts among American Indian and Alaska Native populations?" In doing so, we used the EF (Burnette & Figley, 2016) as a grounding framework for our synthesis. ...
American Indian/Alaska Natives (AI/ANs) experience disproportionate rates of suicide, but current strategies for suicide prevention have not reduced these health disparities. Therefore, to gain insight into factors that may affect risk trajectories for suicide attempts (SAs) among AI/ANs, we conducted a systematic review of the literature. Forty-five articles met inclusion criteria for the final corpus. Results demonstrate that substance use, depression/hopelessness, childhood maltreatment, violent victimization, and friend/family-member death by suicide serve as robust predictors for SAs. For AI/AN youths specifically, risk-taking behaviors, family conflict, and school environment were associated with SAs. Notable differences in risk factors were identified across age, sex, and region. Limitations of this body of evidence are described, including heterogeneity in study design, measurement, and sampling. Predicated on these findings and limitations, we suggest four key strategies to advance the study of risk factors for AI/AN communities to prevent AI/AN suicide.
