“Today we are not good at talking about these things”: A mixed methods study of Inuit parent/guardian-youth sexual health communication in Greenland

Some of the highest rates of sexually transmitted infections (STIs) are reported in the Arctic. For example, the Inuit youth of Greenland have the highest STI rates in the circumpolar region. In this study, we used a mixed method approach to examine parent/guardian–youth communication about STIs and other sexual health topics. The quantitative component of the study involved the parents/guardians completing a brief questionnaire while the qualitative component involved their participation in focus groups. Parents/guardians reported that, although they found little difficulty communicating with youth in general, this was not the case for sexual topics. Similarly, parents/guardians reported a lack of communication about topics such as masturbation, why people engage in sex, and what it feels like to have sex. In general parents/guardians stated that it is uncomfortable for them to talk with their youth about sexual matters. At the same time, they are concerned about the high rates of unwanted pregnancy in their communities, and they would like to see more collaborative partnerships aimed at increasing sexual health education for youth. Future STI prevention efforts in Greenland would benefit from involving Greenlandic youth and their families in the design of community-based sexual health education programs that increase communication skills in families about topics related to sex. Community based efforts that involve families and empower them to educate their youth around STI risk-prevention behaviours is a necessary area of future development in Greenland

“We don’t separate out these things. Everything is related”: Partnerships with Indigenous Communities to Design, Implement, and Evaluate Multilevel Interventions to Reduce Health Disparities

Multilevel interventions (MLIs) are appropriate to reduce health disparities among Indigenous peoples because of their ability to address these communities' diverse histories, dynamics, cultures, politics, and environments. Intervention science has highlighted the importance of context-sensitive MLIs in Indigenous communities that can prioritize Indigenous and local knowledge systems and emphasize the collective versus the individual. This paradigm shift away from individual-level focus interventions to community-level focus interventions underscores the need for community engagement and diverse partnerships in MLI design, implementation, and evaluation. In this paper, we discuss three case studies addressing how Indigenous partners collaborated with researchers in each stage of the design, implementation, and evaluation of MLIs to reduce health disparities impacting their communities. We highlight the following: (1) collaborations with multiple, diverse tribal partners to carry out MLIs which require iterative, consistent conversations over time; (2) inclusion of qualitative and Indigenous research methods in MLIs as a way to honor Indigenous and local knowledge systems as well as a way to understand a health disparity phenomenon in a community; and (3) relationship building, maintenance, and mutual respect among MLI partners to reconcile past research abuses, prevent extractive research practices, decolonize research processes, and generate co-created knowledge between Indigenous and academic communities