Ellen M Keane

University of Colorado | UCD · Centers for American Indian and Alaska Native Health

Evidence of early initiation of substance use among American Indian youth and links between early initiation and substance use disorder make prevention imperative. The Thiwáhe Gluwáš’akapi Program (TG, Sacred home in which family is made strong) is a group-based and family-centered intervention that was culturally adapted from the Strengthening Fam...

Background: Effective substance use prevention strategies are needed for American Indian (AI) youth, who face disproportionate risk for early substance use and consequently bear a disproportionate burden of health and developmental disparities related to early use. With few exceptions, significant advances in prevention science have largely exclude...

Objectives: The Measure of Socialization of American Indian Children (MOSAIC) was created as part of a larger study developing a family-based and culturally grounded substance use prevention program for young American Indian (AI) adolescents. The MOSAIC was designed to measure ethnic-racial socialization (ERS) for use with AI families to support b...

Initiation of substance use often occurs earlier among American Indian (AI) youth than among other youth in the USA, bringing increased risk for a variety of poor health and developmental outcomes. Effective prevention strategies are needed, but the evidence base remains thin for this population. Research makes clear that prevention strategies need...

Objectives: HIV and sexually transmitted diseases (STDs) are serious health conditions among American Indian and Alaska Native (AIAN) populations, especially youth. However, few sexual risk reduction evidence-based interventions (EBIs) have been implemented by AIAN-serving organizations. This project sought to identify and assess the parameters fac...

Evidence-based interventions hold promise for reducing gaps in health equity across diverse populations, but evidence about effectiveness within these populations lags behind the mainstream, often leaving opportunities to fulfill this promise unrealized. Mismatch between standard intervention outcomes research methods and the cultural and community...

We assessed the effectiveness of a culturally grounded, multimedia, sexual risk reduction intervention called Circle of Life (mCOL), designed to increase knowledge and self-efficacy among preteen American Indians and Alaska Natives. Partnering with Native Boys and Girls Clubs in 15 communities across six Northern Plains reservations, we conducted a...

For adolescents, normative development encompasses learning to negotiate challenges of sexual situations; of special importance are skills to prevent early pregnancy, HIV, and other sexually transmitted diseases. Disparities in sexual risk among American Indian youth point to the importance of intervening to attenuate this risk. This study explored...

Background: Early substance use threatens many American Indian/Alaska Native (AI/AN) communities, as it is a risk factor for maladaptive use and adverse health outcomes. Marijuana is among the first substances used by AI/AN youth, and its use becomes widespread during adolescence. Interventions that delay or reduce marijuana use hold the promise o...

Introduction: Substance use disorders are disproportionately prevalent in many American Indian communities, and the consequences of these disparities are far-reaching, both in terms of physical and mental health. Early initiation of substance use is also well documented among American Indian youth, and links between early use and later disorder are...

Objectives: We assessed the effectiveness of Circle of Life (COL), an HIV-preventive intervention developed specifically for American Indian and Alaska Native (AI/AN) middle school youths. Methods: By partnering with a tribal community, we conducted a longitudinal wait-listed group randomized trial with 635 seventh and eighth graders in 13 schoo...

Purpose To describe lessons learned working with tribal communities in the Northern Plains to plan and implement a group randomized trial of multimedia Circle of Life (mCOL), a sexual risk reduction program designed for American Indian (AI) youth. Methods Project records including emails, travel reports, and meeting minutes were reviewed and synth...

Substance use often begins earlier among American Indians compared to the rest of the United States, a troubling reality that puts Native youth at risk for escalating and problematic use. We need to understand more fully patterns of emergent substance use among young American Indian adolescents, risk factors associated with escalating use trajector...

Substantial evidence documents problematic substance use in Northern Plains American Indian communities. Studies suggest that disparities can be traced to disproportionate rates of early substance use, but most evidence comes from the retrospective reports of adults or older adolescents. To use a prospective longitudinal design to examine substance...

In spite of significant disparities in sexual health outcomes for American Indian youth, no studies exist examining the effectiveness of HIV-prevention interventions. Circle of Life is an HIV-prevention intervention specifically developed for American Indian middle-school youth. We describe the rationale, methodology, and baseline results of a long...

Social scientific investigation into the religiospiritual characteristics of American Indians rarely includes analysis of quantitative data. After reviewing information from ethnographic and autobiographical sources, we present analyses of data from a large, population-based sample of two tribes (n = 3,084). We examine salience of belief in three t...

The proximal and distal effects of adversity on the onset of symptoms of substance dependence during adolescence were explored in two culturally distinct American Indian (AI) reservation communities (Northern Plains and Southwest). Data (N=3084) were from the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors...

American Indian adolescents have two to four times the rate of sexually transmitted diseases (STDs) compared to whites nationally, they shoulder twice the proportion of AIDS compared to their national counterparts, and they have a 25% higher level of teen births. Yet little is known about the contemporary expectations, pressures, and norms that inf...

An explicit clinical significance (CS) criterion was added to many DSM-IV diagnoses in an attempt to more closely approximate the clinical diagnostic process and reduce the proportion of false positives in epidemiological studies. The American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project (AI-SUPERPFP) of...

American Indian alcohol use has received scrutiny in recent decades,1 but data derived from samples that permit direct comparisons to other US epidemiological studies have been less commonly reported.2–4 This brief places rates of the quantity and frequency of alcohol use in 2 tribally defined reservation samples in such a comparative epidemiologic...

This article presents data on the prevalence of psychiatric disorders among American Indian adolescents, using DSM-III-R criteria. To generate current prevalence data using a structured diagnostic instrument, the Diagnostic Interview Schedule for Children, Version 2.1C (DISC-2.1C). Youths from a Northern Plains tribe who had participated in an earl...

Suicide is currently the second leading cause of death for ages 15-24 years; reports indicate that 6-8% of American teens have attempted suicide. Rates of suicide and suicide attempts are at least as high, if not higher, for American Indian adolescents and young adults. The Suicidal Ideation Questionnaire (Junior High School Version) (SIQ-JR) could...

This study explored the latent structure of adolescent alcohol use and the construct validity of that structure. Using data gathered from 2,096 American Indian high school students, a double cross-validation design uncovered a three-dimensional latent structure of adolescent alcohol use: quantity/frequency, negative consequences, and serious proble...

A brief, culture-specific, self-report screening measure for depression, the Vietnamese Depression Scale, was used to determine the prevalence of depressive symptoms among 1,998 consecutive adult Vietnamese refugees who presented at 10 public health clinics within 2 months of their arrival in the United States. Of these patients, 6% met the criteri...

The factorial structure of the CES-D among American Indians, specifically adolescents, has been examined. Manson et al. (1990) found a three-factor structure using exploratory factor analysis to be the most appropriate. Similar studies suggest that the four-factor structure found by Radloff (1977) may not be appropriate for some minority samples. S...

To explore the associations between blood pressure and both fasting insulin and C-peptide levels. A cross-sectional analysis was conducted of 895 normoglycemic members of a bi-ethnic community in Colorado who were selected from a control group recruited for a geographically based study of diabetes mellitus prevalence and risk factors. All subjects...

To determine the prevalence of depressive symptoms among Vietnamese refugees who have lived in the United States for at least two months. A prospective and descriptive study using the Vietnamese Depression Scale (VDS). Scores of > or = 13 on the VDS were considered indicative of depression. Ten public health clinics in four states. Four hundred sev...

Depression is among the most prevalent psychopathologies in American Indian communities, but little is known about the performance characteristics of common assessment tools in this population. This article describes the factor structure of the Center for Epidemiologic Studies Depression Scale on the basis of data from a sample of 605 American Indi...

Hyperinsulinemia has been demonstrated in Hispanics with normal glucose tolerance and in other populations at higher risk for non-insulin-dependent diabetes mellitus (NIDDM). We compared fasting and glucose-stimulated insulin and C-peptide levels in a community-based sample of 464 Hispanic and 676 non-Hispanic white adult residents of the San Luis...

The goal of this study was to estimate the effects of childbearing on subsequent glucose tolerance and non-insulin-dependent diabetes mellitus (NIDDM) prevalence. A sample of subjects from 64 different locations in the United States were recruited for inclusion in the Second National Health and Nutrition Examination Survey. A complex survey design...

We performed a population-based, case-control study of the risk of ulcerative colitis associated with coffee and alcohol use among the 304,000 members of a prepaid health plan. We compared coffee and alcohol use histories before ulcerative colitis onset in 209 cases and an equal number of age- and sex-matched controls selected from the enrollment f...

Previous studies of hospitalized and ambulatory patients have found a higher prevalence of Staphylococcus aureus nasal colonization in diabetic than nondiabetic subjects. We examined this association in a geographically based study among 551 residents of the San Luis Valley of Colorado and found no statistically significant increase in the relative...

We assessed the effect of smoking on the clinical course of ulcerative colitis in 209 subjects by comparing disease severity in smokers and non-smokers as measured by yearly number of hospitalizations for ulcerative colitis treatment and the need for a colectomy. Hospitalization for ulcerative colitis treatment occurred less frequently in persons w...

This study examined whether non-insulin-dependent diabetic (NIDDM) subjects have an increased prevalence of asymptomatic bacteriuria compared with subjects with normal glucose tolerance. Diabetic (n = 206) and normal (n = 418) subjects were identified from a defined geographic area in the San Luis Valley of southern Colorado. Presence of asymptomat...

The authors performed a population-based case-control study of the association between weather and occurrence of eclampsia in Washington State. Women who were recorded as having eclampsia on Washington birth certificates from 1980 to 1983 were compared to a random sample of all women who gave birth during those years. For each woman studied, Nation...

OBJECTIVE — To explore the associations between blood pressure and both fasting insulin and C-pep tide levels. RESEARCH DESIGN AND METHODS — A cross-sectional analysis was con-ducted of 895 normoglycemic members of a bi-ethnic community in Colorado who were selected from a control group recruited for a geographically based study of diabetes mellitu...