Utilizing Digital Storytelling and Youth Participatory Approach to Develop a High School Pathway Component to Increase the American Indian Public Health Workforce

BACKGROUND: American Indian individuals are extremely underrepresented in the healthcare and public health workforce. One effective approach to reduce health disparities and improve health care delivery among Indigenous Peoples is to train more American Indian and Alaska Native (AI/AN) health professionals who understand cultural influences on healthcare. This dissertation addressed the need for an AI culturally grounded approach to engage high school students in public health professional opportunities through digital storytelling in a reservation community on the Navajo Nation. OBJECTIVES: This dissertation aims to 1) Establish a community advisory board (CAB) 2) Conduct Digital Storytelling (DST) to assess strategies college students use to navigate from high school to a public health major at and the tribal college; 3) Use Diné Educational Philosophy (DEP) framework and strategies documented in Aim 2 to develop the curriculum 4) Evaluate participation perceptions of the two-phase (DST) process. METHODS: Aim 1, establishment of the CAB formed community over site for the project. Aim 2 focused on utilizing DST in a two- phase process. Phase one consisted of training three AI high school youth in digital storytelling. In phase two, the youth digital storytelling team worked collaboratively with seven AI students enrolled at the local tribal college to develop digital stories (n=10). Aim 3 used backward design to develop the curriculum. Aim 4 is the qualitative analysis of the DST process from the perspective of the AI high school and college students. RESULTS: The results by specific aim yielded 1) Four CAB meetings to guide the project; 2) Seven culturally relevant digital stories and highlighted success strategies in transitioning from high school to college; 3) School-based health profession pathway curriculum; 4) Themes related to participating in the DST process included learning a new skill, building relationships, giving back to the community, as well as distinct findings between the high school and college students. CONCLUSION: The current project resulted in a curriculum for AI high school students to actively engage in exploring health professional pathways in their community. These findings also highlighted the importance of building or strengthening existing relationships between local AI health professionals and tribal college and high school students to form sustainable workforce development programs.Release after 09/06/202

Association between Measures of Women's Empowerment and Use of Modern Contraceptives: An Analysis of Nigeria's Demographic and Health Surveys.

Women's empowerment is hypothesized as a predictor of reproductive health outcomes. It is believed that empowered girls and women are more likely to delay marriage, plan their pregnancies, receive prenatal care, and have their childbirth attended by a skilled health provider. The objective of this study was to assess the association between women's empowerment and use of modern contraception among a representative sample of Nigerian women. This study used the 2003, 2008, and 2013 Nigeria Demographic and Health Survey data. The analytic sample was restricted to 35,633 women who expressed no desire to have children within 2 years following each survey, were undecided about timing for children, and who reported no desire for more children. Measures of women's empowerment included their ability to partake in decisions pertaining to their healthcare, large household purchases, and visit to their family or relatives. Multivariable regression models adjusting for respondent's age at first birth, religion, education, wealth status, number of children, and geopolitical region were used to measure the association between empowerment and use of modern contraceptives. The proportion of women who participated in decisions to visit their relatives increased from 42.5% in 2003 to 50.6% in 2013. The prevalence of women involved in decision-making related to large household purchases increased from 24.3% in 2003 to 41.1% in 2013, while the proportion of those who partook in decision related to their health care increased from 28.4% in 2003 to 41.9% in 2013. Use of modern contraception was positively associated with women's participation in decisions related to large household purchases [2008: adjusted OR (aOR) = 1.15; 95% CI = 1.01-1.31] and (2013; aOR = 1.60; 1.40-1.83), health care [2008: (aOR = 1.20; 1.04-1.39) and (2013; aOR = 1.39; 1.22-1.59)], and visiting family or relatives [2013; aOR = 1.58; 1.36-1.83]. The prevalence of modern contraceptive use among women with need for contraception increased marginally from 11.1% in 2003 to 12.8% in 2013. Although there were marked improvements in all measures of women's empowerment between 2003 and 2013 in Nigeria, the use of modern contraceptives increased only marginally during this period. Beyond women's participation in household decision-making, further research is needed to elucidate how measures of women's empowerment interact with cultural values and health system factors to influence women's uptake of contraceptives.Open access journal.This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at [email protected]

A pilot study of the epilepsy risk awareness checklist (ERAC) in people with epilepsy and learning disabilities

Original article can be found at: http://www.sciencedirect.com/science/journal/10591311 Copyright BEA Trading Ltd. [Full text of this article is not available in the UHRA]Purpose: People with epilepsy are at risk of injury, and protection from potential dangers must be balanced against the need for autonomy. We developed an epilepsy risk awareness checklist (ERAC) as a tool to assess potential risks of epilepsy and related injuries, aiming to improve management strategies. It was designed for use by specialist nurses (in learning disability and epilepsy), as there was no existing tool for this. This study refined and tested this checklist in patients with epilepsy and learning disability in a range of community settings.Peer reviewe