Talking Circle Intervention Among Urban Native American Youth: A Cultural Safety Research Exemplar

Urban Native Americans are experiencing a perpetual cycle of substance use in relation to historical trauma (HT). Currently, alcohol and drug use has become a leading health risk factor among urban Native American youth. Cultural Safety is a means to foster insight and autonomy that is beneficial to promoting health and wellbeing among Native American and Indigenous people. The primary objective of this paper examined implementation of the Urban Talking Circle Intervention and cultural safety for the prevention of alcohol and drug use among urban Native American youth. This study employed a 2-condition quasi experimental design and utilized convenience and snowball sampling methods to recruit 100 urban Native American youth from two urban Native American community programs that were randomized by program site. Integration of Native-Reliance Theory, a community-based program approach, and the Urban Talking Circle Intervention, culturally tailored from the evidenced based Talking Circle Intervention guided the study. Evidence from the results of this study emphasized that alcohol and drug use prevention programs that are culturally centered and guided by cultural values, beliefs, and perspectives promotes an environment for cultural safety research to be conducted.Culturally safe interventions for urban Native American youth build their resiliency against avoiding alcohol and drug use interests and choices that result in high-risk behaviors and harmful health outcomes

Discrimination, Racism, Social Inequality, and Injustice Experienced Among Native Hawaiians through the Lens of Historical Trauma

The purpose of this study was to explore the lived experiences of colonization and historical trauma and links to alcohol among Native Hawaiians living in rural Hawaii. Native American groups including, American Indians, and Alaska Natives have experienced historically traumatic events over the past 500 years, after contact with Europeans. Some Indigenous scholars have posited that historical trauma is a primary cause of the current social pathology and health disparities in Native Hawaiians. A phenomenological design was selected for this study using Indigenous storytelling methodology. Two themes emerged including: a) the participants described experiences of negative stereotyping that leads to perceived discrimination and racism which is a trigger for increased thoughts of historical losses including the loss of identity: b) the participants described experiences of social inequality and injustices which has increased the use of alcohol and methamphetamine as a way to cope by self-medicating There remains the need for investigators to examine whether the type of experiences of discrimination, racism, social inequality, and injustice differ for people of various racial-ethnic backgrounds, especially Indigenous people. It is necessary for researchers to examine the impact of these experiences to clarify the prevalence and effects on health and health behaviors

Sexual and reproductive health and access : Results of a rapid epidemiological assessment among migrant peoples in transit through Darién, Panamá

Background: The foot transit of migrant peoples originating from the Caribbean, South America, Asia, and Sub-Saharan Africa through the Darién Forest (DF) in Eastern Panamá towards North America has increased in recent years from approximately 30,000 people/year to >133,000 in 2021. In the DF, there is no food/housing provision nor healthcare access. Very little is known of sexual and reproductive health (SRH) among this population. This study used rapid epidemiological methods to describe the SRH situation among migrant peoples in transit through the DF. Methods: This cross-sectional study randomly selected migrant people in transit (men and women) at a Migrant Reception Station in Darién, Panamá, between January 4-11, 2022. Data collection included a self-applied questionnaire (≥18 years); clinical screening (≥12 years); and HCG, treponemal antibodies, and HIV(I/II) lateral-flow tests with blood samples (≥12 years). Descriptive analyses were used to report findings. Results: In all, 69 men and 55 women participated in the self-applied questionnaire, 70 men and 51 women in clinical screening; 78 men and 63 women in HCG, treponemal antibody and HIV testing. Overall, 26.1% (18/69) men and 36.4% (20/55) women reported sexual intercourse within the past month. The last sex partner was casual among 43.0% (21/49) of men and 27.8% (10/36) of women; of those, 42.9% (9/21) of men and 80.0% (8/10) of women reported this sex was condomless. Among women, 20.0% (11/55) tested positive for pregnancy; 5 of these pregnancies were planned. Of those screened, a reproductive tract infection symptom was reported by 5.7% (4/70) of men and 58.8% (30/51) of women. A total of 32.7% (18/55) of men and 18.2% (8/44) of women reported no prior HIV testing. Of 78 men, HIV and treponemal antibodies were found among 1.3% (n = 1) and 2.6% (n = 2), and among 63 women, 3.2% (n = 2) and 3.2% (n = 2), respectively. Conclusions: This rapid epidemiological assessment found high recent sexual activity, low condom use with casual partners, and a need for increased HIV and syphilis testing and treatment. There is a need for increased testing, condom provision, and SRH healthcare access at migrant reception stations that receive migrant peoples in transit through Panamá

Camulative trauma among adult mayas living in southeast Florida

The toxic combination of social, psychological, environmental, cultural, and physiological trauma Mayas living in Southeast Florida face daily places them at higher risk for mental and physical disorders (Marmot & Wilkinson, 2006; WHO, 2010, September). The burden of disease is not limited to mental disorder comorbidities; psychological stress can also induce or exacerbate chronic medical diseases such as obesity, diabetes, and hypertension (Brunner & Marmot, 2006; Sridhar, 2007). This translates to high levels of morbidity, mortality, and disability among ethnically diverse populations (U.S. Department of Health and Human Services, 2001). The continuation of this disregard will add to the health disparity of this nation by delaying assessment, treatment, and development of interventions. The purpose of this study was to explore cumulative trauma as it related to social determinants of health and pathophysiological, psychological, and health behaviors of 102 adult Mayas living in Southeast Florida. The trauma profile for the Mayan population sample obtained through this study reflected high exposure to different types of trauma; collective identity trauma was most frequently reported, followed by survival trauma, achievement trauma, secondary trauma, and personal identity trauma, with high rates of repetition of the same traumas. Cumulative trauma emerged as the most significant type of trauma, in that it addresses the combination of all similar and dissimilar traumas in the lifespan of a person. Data also revealed that language combined with literacy level may play a role on how populations such as the Mayas report symptoms, as Spanish is a second language for Mayas, with few being able to read it fluently. The findings in this study confirmed that high levels of cumulative trauma dose and the social determinants of health are embedded throughout the cultural experience of the Mayan people, which in the present day manifests as mild forms of depression symptoms for women and moderate alcohol use risk for men. Key words: Maya; alcohol; ASSIST; cumulative trauma; Beck Depression Inventory-II; genocide; Guatemala; Hispanic; social determinants of health

Addressing Substance Use Utilizing a Community-Based Program among Urban Native American Youth Living in Florida

This study was conducted in Florida among two urban Native American youth programs that are sponsored by urban Native American community organizations. Convenience and snowballing were used as a sample recruitment strategy. Assignment to the experimental condition (UTC) and the control condition (SE) was established by randomizing the two community youth program sites to the two conditions. Utilization of a culturally relevant theory, Native-Reliance, guided the intervention approach for the prevention of substance use among urban Native American youth. Results of this study provided evidence that a culturally based intervention was significantly more effective for the reduction of substance use interest and general well-being than a non-culturally based intervention for urban Native American youth. Prevention programs for urban Native American early adolescent youth that utilize Native American strengths, values, and beliefs to promote healthy behavior and reduce the harm associated with high-risk behaviors such as substance use are strongly recommended

Dating violence prevalence and risk factors among adolescents (14-19 years) in urban public schools in Panama.

BACKGROUND: Adolescent dating violence (ADV) can have lasting effects on youth's well-being and development. However, few studies in Latin America have described its prevalence and risk factors for having experienced ADV. METHODS: We conducted a multisite, cross-sectional study using two-stage cluster sampling among adolescents (14-19 years) attending public high schools in the urban districts of Panama, San Miguelito, Colón, and Arraiján/La Chorrera from 2015 to 2018 (N = 2469). All completed a tablet-based, self-administered questionnaire. Random effects logistic regression was used to identify risk factors for each ADV type among adolescent boys and girls separately. FINDINGS: Participants reported experiencing a range of ADV at least once (girls: emotional 61.6%, physical 7.9%, sexual 21.0%; boys: emotional 73.4%, physical 24.1%, sexual 28.9%). In adjusted models, participants with a history of sexual intercourse had greater odds of ADV than those without such history across types (boys: emotional and sexual; girls: emotional, physical, and sexual). Additionally, participants who reported three or more romantic partners in the past year had greater odds of ADV than those with one partner (boys: emotional, physical; girls: physical). Girls with an earlier sexual debut (≤14 years vs ≥15 years) had greater odds of reporting ADV (emotional and sexual violence). No associations were found between reporting dating violence survival and the sex of romantic partners in the past year or the age of the current/most recent sex partner. INTERPRETATION: This study reveals a high prevalence of ADV among adolescents in urban public schools in Panama. These findings support the need for program implementation to address ADV. FUNDING: Funding to undertake this study was acquired from Panama's Ministry of Economics and Finance, project number 009044.049

Dating violence prevalence and risk factors among adolescents (14–19 years) in urban public schools in PanamaResearch in context

Summary: Background: Adolescent dating violence (ADV) can have lasting effects on youth's well-being and development. However, few studies in Latin America have described its prevalence and risk factors for having experienced ADV. Methods: We conducted a multisite, cross-sectional study using two-stage cluster sampling among adolescents (14–19 years) attending public high schools in the urban districts of Panama, San Miguelito, Colón, and Arraiján/La Chorrera from 2015 to 2018 (N = 2469). All completed a tablet-based, self-administered questionnaire. Random effects logistic regression was used to identify risk factors for each ADV type among adolescent boys and girls separately. Findings: Participants reported experiencing a range of ADV at least once (girls: emotional 61.6%, physical 7.9%, sexual 21.0%; boys: emotional 73.4%, physical 24.1%, sexual 28.9%). In adjusted models, participants with a history of sexual intercourse had greater odds of ADV than those without such history across types (boys: emotional and sexual; girls: emotional, physical, and sexual). Additionally, participants who reported three or more romantic partners in the past year had greater odds of ADV than those with one partner (boys: emotional, physical; girls: physical). Girls with an earlier sexual debut (≤14 years vs ≥15 years) had greater odds of reporting ADV (emotional and sexual violence). No associations were found between reporting dating violence survival and the sex of romantic partners in the past year or the age of the current/most recent sex partner. Interpretation: This study reveals a high prevalence of ADV among adolescents in urban public schools in Panama. These findings support the need for program implementation to address ADV. Funding: Funding to undertake this study was acquired from Panama's Ministry of Economics and Finance, project number 009044.049

U.S. bound journey of migrant peoples InTransit across Dante's Inferno and Purgatory in the Americas

Rapid rise of population migration is a defining feature of the 21st century due to the impact of climate change, political instability, and socioeconomic downturn. Over the last decade, an increasing number of migrant peoples travel across the Americas to reach the United States seeking asylum or cross the border undocumented in search of economic opportunities. In this journey, migrant people experience violations of their human rights, hunger, illness, violence and have limited access to medical care. In the ‘Divine Comedy’, the Italian poet Dante Alighieri depicts his allegorical pilgrimage across Hell and Purgatory to reach Paradise. More than 700 years after its publication, Dante's poem speaks to the present time and the perilious journey of migrant peoples to reach safehavens. By exploring the depths and heights of the human condition, Dante's struggles resonate with the multiple barriers and the unfathomable experiences faced by migrant peoples in transit across South, Central, and North America to reach the United States. Ensuring the safety of migrant peoples across the Americas and elsewhere, and attending to their health needs during their migratory paths represent modern priorities to reduce social injustices and achieving health equity.Fund Neglected Tropical Diseases of the University of Colorado by Mr. Howard Janzen