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ICR Abstracts: 5.8
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Helena
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Aug 20, 2007 11:32 PDT
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Editor's note: The following articles have been selected because they
collectively deal with a variety of issues related to community-based
research (e.g., collaboration, ethics, methods) and they cover various
disciplines. If you have suggestions for articles/publications for
future postings, or other feedback in the
presentation, simply reply to this email. Thanks for joining!]
ICR Abstracts (5.8: August 20, 2007)
1. Andrews, J. O., G. Bentley, et al. (2007). Using community-based
participatory research to develop a culturally sensitive smoking
cessation intervention with public housing neighborhoods. _Ethnicity &
Disease_, 17(2), 331-7.
PURPOSE: To describe surface and deep structure dimensions of a
culturally sensitive smoking cessation intervention developed with
southeastern US public housing neighborhoods. PROCEDURES:
Community-based participatory research (CBPR) methods were used to
develop this culturally sensitive smoking cessation intervention by the
following research partners: academicians, neighborhood residents,
community health workers, and community advisory board. This CBPR
involved a cyclical process with the following phases: assembling a
research team; identifying smoking cessation as the health need of
interest; developing the research method; establishing evaluation,
feedback, and dissemination mechanisms; implementing the initial "Sister
to Sister" community trial; analyzing and interpreting the data;
disseminating the results; revising the intervention; and, establishing
mechanisms to sustain outcomes. Culturally sensitive dimensions emerged
during this process and were categorized as surface structure and deep
structure. FINDINGS: Surface structure dimensions included written
materials, incentives and food, and protocol delivery strategies. Deep
structure dimensions included kinships, collectivism, storytelling, and
spiritual expressions. Community health workers and the advisory board
contributed to the identification and integration of both surface and
deep structure dimensions. The six-month continuous smoking abstinence
outcomes from the initial community trial were 27.5% vs 5.77% for the
intervention and comparison groups, respectively. CONCLUSIONS:
Community-based participatory research (CBPR) methods facilitate
processes in which culturally sensitive dimensions can be effectively
identified and integrated into health promotion interventions for
marginalized populations. The incorporation of surface structure
dimensions increases acceptance and feasibility, while deep structure
improves overall impact and efficacy of the intervention.
2. Carrasquillo, O. and L. A. Chadiha. (2007). Development of
community-based partnerships in minority aging research. _Ethnicity &
Disease_, 17(1 Suppl 1), S3-5.
The Resource Centers for Minority Aging Research (RCMAR) initiative was
established in 1997 and currently includes six centers across the United
States. The model of community engagement developed by all the RCMARs is
Community Based Participatory Research (CBPR). This supplement explores
the diverse methods of partnership building in each RCMAR and highlights
some of the successes and challenges encountered in CBPR. Two articles
focus on how the CBPR infrastructure facilitates the conduct of research
in minority communities. Two other manuscripts discuss the unique
experiences at those RCMARs in the CBPR partnership development process.
The final paper describes the mentoring processes used at each of the
RCMARs for both junior academic investigators and community members. We
conclude that CBPR is a difficult and long-term process requiring
substantial buy-in and commitments from both the academic and community
partners in a continuous and evolving collaborative partnership.
3. Farquhar, S., J. Samples, et al. (2007). Promoting the Occupational
Health of Indigenous Farmworkers. _Journal of Immigrant and Minority
Health_, [Epub, ahead of print].
In the United States, approximately 78% of agricultural farmworkers are
immigrants. In Oregon, a growing number of these farmworkers are
indigenous and speak an indigenous language as their primary language.
This group of farmworkers suffers from linguistic, cultural and
geographic isolation and faces a unique set of challenges yet little has
been done to identify their health needs. Using data from focus groups,
partners from this community-based participatory research project
examined indigenous farmworkers' concerns regarding occupational injury
and illness, experiences of discrimination and disrespect, and language
and cultural barriers. The data revealed examples of disrespect and
discrimination based on the languages and cultures of indigenous
farmworkers, and a lack of basic occupational health and safety
information and equipment. For example, participants mentioned that
occupational safety information was inaccessible because it was rarely
provided in indigenous languages, and participants felt there were no
legal means to protect farmworkers from occupational hazards.
Community-based strategies designed to address the occupational health
status of farmworkers must consider the unique circumstances of those
farmworkers who do not speak Spanish or English.
4. Flicker, S. and B. Savan (2007). "A snapshot of community-based
research in Canada". Toronto, ON Wellesley Institute: 42.
Community-Based Research (CBR) is rapidly gaining recognitions as an
important tool in addressing complex environmental, health and social
problems. However, little is known about the Canadian CBR context. A
web-based survey including 25 questions was circulated on listservs and
via targeted e-mails to investigate the status of CBR in Canada.
Univariate and bivariate statistical analyses were performed to examine
variables and relationships of interest. Our sample included a
cross-section of CBR community and academic practitioners (n = 308).
Respondents reported a wide range of project foci, experience, operating
budgets and reasons for engaging in their last CBR endeavor. Academic
partners were perceived to be most involved at all stages of the
research process except dissemination. Service providers were also
perceived as being very involved in most stages of research. Community
members were substantially less engaged. High levels of satisfaction
were reported for both CBR processes and outcomes. Respondents reported
a number of positive outcomes as a result of their research endeavors,
including changes in both agency and government policies and programs.
Our study shows that CBR practitioners are engaged in research on a wide
array of Canadian health and social issues that is making a difference.
Finding appropriate levels of participation for community members in CBR
remains an ongoing challenge.
Full text available online:
http://www.uvic.ca/research/ocbr/assets/pdfs/CBR_snapshot_report_final.pdf
5. George, M. A., M. Daniel, et al. (2007). Appraising and funding
participatory research in health promotion. _International Quarterly of
Community Health Education_, 26(2), 171-87.
Participatory action research combines research, education and social
action. Each of these elements reflects health education research and
practice. Indeed, health education, health promotion and participatory
research have converged in these respects. Participatory research is
well suited to the philosophies and theories underpinning
community-based health education and health promotion. The nature of
participatory research is such that funding agencies, especially those
awarding research funds, tend to be challenged in their attempts to
assess proposals. This is true at least for those agencies operating
under traditional criteria for reviewing standards, which may not be
appropriate for participatory research. As well, it may reflect a
broader lack of common understanding about the processes and
expectations, the apparent untidiness of projects (comparing with
traditional research) which by their nature offer no standard methods,
deadlines, procedures or predetermined outcome measures. The Study of
Participatory Research in Health Promotion [1], commissioned by the
Royal Society of Canada, attempted to clarify the topic by providing a
working definition and a set of guidelines for use by funding agencies
when appraising projects purporting to be participatory research. The
guidelines emphasize how the nominal ways of conducting health research
in populations need to adapt to meet the educational and policy
expectations of participatory research. The study also examined current
practical examples of participatory research in the field of health
promotion in Canada. This summary of the results of the project provides
detailed guidelines flowing from a review of experience in the field and
consultation with groups engaged in participatory research.
6. Hewitt, G., A. Draper, et al. (2007). Improving food provision in a
Guyanese home for the elderly: A participatory approach. _Public Health
Nutrition_, 10(6), 552-8.
OBJECTIVES: To conduct a needs assessment of all aspects of food
provision in a residential home and to evaluate a subsequent nutrition
intervention. DESIGN: An intervention study using a before and after
design. A participatory approach was adopted and quantitative and
qualitative methods used throughout. The intervention involved a revised
menu, kitchen equipment, and establishing wholesale shopping and food
donations. SETTING: A residential home for senior citizens in Guyana.
RESULTS: Meals at the home were nutritionally inadequate and deeply
unpopular with the residents. Intakes of fruits and vegetables were low
and the home was heavily reliant on donated soya mince and rice. Meals
were served within an eight-hour period to accommodate the staff's hours
of work. Cutbacks in the food budget indicated that the financial state
of the home explained some of the problems. The intervention was unable
to address all problems identified, but led to substantial improvements
in the nutritional adequacy of the food provided following the inclusion
in the menu of a number of nutrient-dense foods such as chicken liver.
The new menu was acceptable to the cooks and largely popular with the
residents, although some problems persisted. CONCLUSIONS: The results
show that improvements in the nutrient profile of the diet could be
achieved with a flexible, community-based, participatory approach that
addressed all elements of a home's food provision system. The changes
also proved largely popular with the residents, thus potentially
contributing to their quality of life.
7. Kelly, C. M., E. A. Baker, et al. (2007). Translating research into
practice: Using concept mapping to determine locally relevant
intervention strategies to increase physical activity. _Evaluation and
Program Planning_, 30(3), 282-93.
PURPOSE: To translate intervention strategies to increase physical
activity interventions recommended by the Community Guide for higher and
lower income African-American adults living in an urban, Midwestern
community. METHOD: Structured interviews were conducted with a
stratified random sample of African-American men and women from high-
and low-income groups. Data were analyzed using concept mapping, a
six-step process that incorporates qualitative and quantitative
analysis. RESULTS: The results suggest differences among men and women,
high and low income, in the conceptualization of factors associated with
physical activity behavior. The different conceptualizations suggest
different intervention strategies and action steps may be necessary for
subgroups of a population. CONCLUSION: Concept mapping is a
participatory method that community members and health practitioners can
use to develop locally defined intervention strategies. From the
strategies and action steps identified, evidence-based interventions can
be developed in light of the optimal characteristics necessary within a
community.
8. Lee, S., S. C. Fung, et al. (2007). Delay in initial treatment
contact after first onset of mental disorders in metropolitan China.
_Acta Psychiatrica Scandinavica_, 116(1), 10-16.
Objective: There has been no community-based research on treatment delay
among people with mental disorders in China. This study examines
lifetime treatment and treatment delay in metropolitan China. Method: A
multi-stage probability survey of 5201 respondents was administered in
Beijing and Shanghai. Age of first treatment contact after onset of each
of the three lifetime DSM-IV/CIDI disorder classes was compared with
retrospective information on age of disorder onset. Length and
predictors of treatment delay were examined using survival analysis.
Results: Survival curves estimate that 44.7%, 25.7%, and 7.9% of people
with anxiety, substance, and mood disorders, respectively, will ever
make treatment contact. Delays in first treatment contact of anxiety (21
years) and substance (17 years) disorders are longer than that of mood
disorders (1 year). These delays are largely unrelated to
sociodemographic variables. Conclusion: Failure to receive treatment is
a pervasive phenomenon among people with mental disorders in
metropolitan China.
9. Lipscomb, H. J., C. A. Epling, et al. (2007). Musculoskeletal
symptoms among poultry processing workers and a community comparison
group: Black women in low-wage jobs in the rural south. _American
Journal of Industrial Medicine_, 50(5), 327-338.
Background Poultry processing is characterized by rapid line speed and
extreme division of labor. Morbidity associated with this work has been
reported by scientists, journalists and workers in this fast growing
industry. Methods Cross-sectional data from baseline measures of a
cohort of black women employed in poultry processing (n = 291) and a
community comparison group (n = 299) in rural North Carolina were used
to evaluate musculoskeletal symptom reports and to explore factors
associated with those reports. Recruitment of participants and
collection of data were performed by women in the community
circumventing the need to involve employers. Results Significant
differences in musculoskeletal symptom prevalence were observed between
women employed in poultry processing and those of similar economic
status employed elsewhere in the same area of rural northeastern North
Carolina. After adjusting for other factors independently associated
with symptoms among these women including age, depression, and perceived
isometric load at work, the prevalence of upper extremity and neck
symptoms was 2.4 (95% CI 1.7, 3.2) times higher among women working in
poultry processing. Conclusions The findings add to the documentation of
occupational health concerns among vulnerable workers employed in
poultry processing in our state; in this economically depressed area of
rural northeastern North Carolina poultry processing is the largest
single employer of women. On a larger scale, the potential magnitude of
upper extremity morbidity among women employed in poultry processing
should be viewed with the knowledge that poultry processing is a growing
industry in the U.S. with work done largely by blacks and immigrants.
10. Marshall-Lucette, S., K. Corbett, et al. (2007). Developing locally
based research capacity in Uganda. _International Nursing Review_,
54(3), 227-233.
Aim: To describe an educational project to enhance local research
capacity within Hospice Africa Uganda, a Uganda-wide community-based
palliative care organization. Background: This project emerged from a
British Council Higher Education Links Scheme involving stakeholder
British and Ugandan higher education institutions. The paper describes
the project in relation to the remit of the British Council, the Ugandan
context and the specifics of this exploratory project. The aim of the
project was to build on the pre-existing local research capacity.
Findings: The lessons learnt and the participatory approach adopted for
meeting the challenges of teaching/learning that emerged from this
project are described in relation to the local interprofessional,
organizational, socio-economic and socio-cultural contexts. Conclusion:
Local knowledge gained through participatory engagement and
collaborative working within Uganda is relevant and useful for current
and future UK-Ugandan higher education partnerships.
11. Martsolf, D. S., T. J. Courey, et al. (2006). Adaptive sampling:
Recruiting a diverse community sample of survivors of sexual violence.
_Journal of Community Health Nursing_, 23(3), 169-82.
Accessing vulnerable and hard-to-reach populations is a significant
challenge for nurse researchers. Adaptive sampling is a procedure that
has been used effectively in community-based research to recruit rare or
hidden populations. Structured community assessment, as practiced by
community health nurses, can be used to enhance adaptive sampling
procedures to recruit research participants. This article(1) describes
adaptive sampling techniques, discusses how the techniques can be
enhanced with a structured nursing community assessment, and describes
how adaptive sampling was used successfully by nurse researchers to
obtain a diverse and vulnerable community sample for a grounded-theory
study of women's and men's responses to sexual violence.
12. Mendis-Millard, S. and M. G. Reed. (2007). Understanding community
capacity using adaptive and reflexive research practices: Lessons from
two Canadian biosphere reserves. _Society & Natural Resources_, 20(6),
543-559.
Community-based ecosystem management requires understanding a
community's capacity. We argue that communities can make important
contributions not only to specific assessments of community capacity,
but also to the conceptualization of the term itself through
community-based research methods that are both adaptive and reflexive. A
research initiative that illustrates such practices is reported here. We
begin by describing our initial conceptual framework of community
capacity that identified resource capitals and mobilizing factors. In
focus groups, residents of two Canadian biosphere reserves used this
framework to assess their capacity to meet biosphere reserve mandates
and to provide critical reflections that helped to drive revisions to
the framework. Our new framework is more sensitive to temporal and
spatial dimensions of capacity, local social relations, and local
culture. We conclude that adaptive and reflexive community-based offer
methodological alternatives for research, help advance conceptions of
community capacity, and help produce social change.
13. Michael, Y. L., S. A. Farquhar, et al. (2007). Findings from a
Community-based Participatory Prevention Research Intervention Designed
to Increase Social Capital in Latino and African American Communities.
_Journal of Immigrant and Minority Health_, [Epub ahead of print].
A community-based participatory research intervention, Poder es
Salud/Power for Health, employed Community Health Workers who used
popular education to identify and address health disparities in Latino
and African American communities in a metropolitan area in the United
States. We assessed participants' social capital, self-rated health, and
depressive symptoms at baseline and the end of the intervention. Social
support and self-rated health improved while depressive symptoms
decreased. Public health interventions involving diverse communities
that are designed to build upon assets, such as existing levels of
social capital, may improve health in those communities.
14. Norris, K. C., R. Brusuelas, et al. (2007). Partnering with
community-based organizations: An academic institution's evolving
perspective. _Ethnicity & Disease_, 17(1 Suppl 1), S27-32.
BACKGROUND: Community-based participatory research (CBPR) is ideally a
collaborative approach to research that equitably involves all partners
in the research process and recognizes the unique strengths that each
brings. METHODS: We reviewed the processes, strategies, and activities
around the interface of community-academic partnerships using a CBPR
model focused on addressing healthcare issues for minority elders.
RESULTS: Key challenges for the community side include understanding:
(1) the needs of the academic partner; (2) how to assess whether there
are shared values, goals, and research priorities; (3) the limits of
one's organization and competing demands; (4) how to use the partnership
to build community capacity to conduct research; and (5) the value added
for the community from involvement in research versus the risks inherent
in participation. Key challenges for the academic side of the
partnership include understanding: (1) what community is; (2) the value
added by a true partnership; (3) how to build effective relationships;
(4) what a balanced collaboration with equal power sharing entails; (5)
that community partner goals may not mirror academic goals; (6) the
capabilities and limits of community partners; and (7) how to
effectively use a community advisory board (CAB). Building relationships
and effective collaboration require time, patience, physical presence,
respect, and commitment-elements frequently in short supply in a busy
academic environment. A memorandum of understanding (MOU) can be an
important tool to document roles and responsibilities. The community
advisory board (CAB) is an important liaison between the community and
academic settings but is not sufficient to constitute a partnership in
and of itself. Members should be carefully selected so that the CAB can
assist in: (1) creating a partnership roadmap; (2) providing contacts
and strategies; (3) helping to broker competing agendas; (4) helping
provide a balance in articulating the community health priorities; (5)
giving additional perspectives and balance for the partnerships; and (6)
participating as a critical component of the mentor pool. CONCLUSION:
Our evolving perspective on CBPR has reinforced the importance of a MOU
to document the roles and expectations of each partner and a carefully
selected CAB to develop and enhance true collaboration with community
partners. We cannot overemphasize the importance of educating academia
to truly value the role of community and resident experts as equitable
and necessary partners to most effectively perform quality research and
ultimately bring evidenced-based care for diverse elderly communities
into a real-life setting.
15. Nyamathi, A. M., M. Suhadev, et al. (2007). Perceptions of a
community sample about participation in future HIV vaccine trials in
South India. _AIDS and Behavior_, 11(4), 619-627.
Focus group discussions were conducted to assess factors that might
impact participation of subgroups in Chermai for future HIV vaccine
trials. The participants were 112 men and women representing the
following: (1) transport workers; (2) clients who attended a sexually
transmitted disease clinic; (3) injection drug users; (4) men having sex
with men; (5) women in sex work; and (6) monogamous married women.
Participants expressed an intense interest in future HIV vaccine trials.
Willingness to participate in future trials included altruism and the
desire to have a protective vaccine for the future. Assurances
regarding, stigma and confidentiality, and compensation for families in
the event of a poor outcome with a future HIV vaccine trial were
reported. Concerns also centered on the impact of seroconverting, and a
possible increase in risk behaviors. The need for education and
counseling about the dangers of engaging in risky behavior during and
after participating in a future HIV vaccine trial is discussed.
16. Ridde, V. (2007). Reducing social inequalities in health: Public
health, community health or health promotion? _Promotion & Education_,
14(2), 63-7, 111-4.
While the Consortium on 'Community Health Promotion' is suggesting a
definition of this new concept to qualify health practices, this article
questions the relevance of introducing such a concept since no one has
yet succeeded in really differentiating the three existing processes:
public health, community health, and health promotion. Based on a
literature review and an analysis of the range of practices, these three
concepts can be distinguished in terms of their processes and their
goals. Public health and community health share a common objective, to
improve the health of the population. In order to achieve this
objective, public health uses a technocratic process whereas community
health uses a participatory one. Health promotion, on the other hand,
aims to reduce social inequalities in health through an empowerment
process. However, this is only a theoretical definition since, in
practice, health promotion professionals tend to easily forget this
objective. Three arguments should incite health promoters to become the
leading voices in the fight against social inequalities in health. The
first two arguments are based on the ineffectiveness of the approaches
that characterize public health and community health, which focus on the
health system and health education, to reduce social inequalities in
health. The third argument in favour of health promotion is more
political in nature because there is not sufficient evidence of its
effectiveness since the work in this area is relatively recent. Those
responsible for health promotion must engage in planning to reduce
social inequalities in health and must ensure they have the means to
assess the effectiveness of any actions taken.
17. Taylor-Piliae, R. E., E. S. Froelicher, et al. (2007). Methods to
optimize recruitment and retention to an exercise study in Chinese
immigrants. _Nursing Research_, 56(2), 132-6.
BACKGROUND: To counter pervasive disparities in healthcare and guide
public health prevention programs, culturally sensitive recruitment and
retention strategies for Chinese immigrants participating in
health-related research studies are needed. OBJECTIVES: The aim of this
study was to develop and implement recruitment and retention strategies
with Chinese immigrants in a Tai Chi exercise study. METHODS: After
substantial project planning and incorporating community-based research
principles, a multidimensional approach was used to ensure minimal loss
to follow-up. Recruitment strategies included partnering with a
community-based agency, distributing study information using a
multimedia approach, communicating in the native language, and
demonstrating cultural sensitivity. Retention strategies included
establishing a tracking method during recruitment, providing
personalized feedback, maintaining the same location for all aspects of
the study, eliminating potential linguistic barriers, providing personal
attention and encouragement, monitoring attendance, utilizing a
charismatic Tai Chi instructor, respecting Chinese culture, providing
appropriate incentives, and maintaining good communication. RESULTS:
Sixty persons showed interest in the study, 52 persons were screened,
and 39 persons were enrolled. Recruitment was completed within 3 weeks.
An advertisement in the Chinese newspaper was the most fruitful
recruitment source, yielding approximately 60% of the study
participants. Retention in the study was also very high (97%, n = 38).
DISCUSSION: The successful recruitment and retention of Chinese
immigrants in this Tai Chi exercise study are due to a variety of
factors on many levels, including the participants, study investigator,
and community-based agency.
18. UyBico, S. J., S. Pavel, et al. (2007). Recruiting vulnerable
populations into research: A systematic review of recruitment
interventions. _Journal of General Internal Medicine_, 22(6), 852-863.
BACKGROUND: Members of vulnerable populations are underrepresented in
research studies. OBJECTIVE: To evaluate and synthesize the evidence
regarding interventions to enhance enrollment of vulnerable populations
into health research studies. DATA SOURCES: Studies were identified by
searching MEDLINE, the Web of Science database, personal sources, hand
searching of related journals, and article references. Studies that
contained data on recruitment interventions for vulnerable populations
(minority, underserved, poor, rural, urban, or inner city) and for which
the parent study (study for which recruitment was taking place) was an
intervention study were included. A total of 2,648 study titles were
screened and 48 articles met inclusion criteria, representing 56 parent
studies. Two investigators extracted data from each study. RESULTS:
African Americans were the most frequently targeted population (82% of
the studies), while 46% targeted Hispanics/Latinos. Many studies
assessed 2 or more interventions, including social marketing (82% of
studies), community outreach (80%), health system recruitment (52%), and
referrals (28%). The methodologic rigor varied substantially. Only 40
studies (71%) incorporated a control group and 21% used statistical
analysis to compare interventions. Social marketing, health system, and
referral recruitment were each found to be the most successful
intervention about 35-45% of the studies in which they were attempted,
while community outreach was the most successful intervention in only 2
of 16 studies (13%) in which it was employed. People contacted as a
result of social marketing were no less likely to enroll than people
contacted through other mechanisms. CONCLUSIONS: Further work with
greater methodologic rigor is needed to identify evidence-based
strategies for increasing minority enrollment in research studies;
community outreach, as an isolated strategy, may be less successful than
other strategies.
19. Wakefield, S., F. Yeudall, et al. (2007). Growing urban health:
Community gardening in South-East Toronto. _Health Promotion
International_, 22(2), 92-101.
This article describes results from an investigation of the health
impacts of community gardening, using Toronto, Ontario as a case study.
According to community members and local service organizations, these
gardens have a number of positive health benefits. However, few studies
have explicitly focused on the health impacts of community gardens, and
many of those did not ask community gardeners directly about their
experiences in community gardening. This article sets out to fill this
gap by describing the results of a community-based research project that
collected data on the perceived health impacts of community gardening
through participant observation, focus groups and in-depth interviews.
Results suggest that community gardens were perceived by gardeners to
provide numerous health benefits, including improved access to food,
improved nutrition, increased physical activity and improved mental
health. Community gardens were also seen to promote social health and
community cohesion. These benefits were set against a backdrop of
insecure land tenure and access, bureaucratic resistance, concerns about
soil contamination and a lack of awareness and understanding by
community members and decision-makers. Results also highlight the need
for ongoing resources to support gardens in these many roles.
20. Wexler, L. and B. Goodwin. (2006). Youth and adult community member
beliefs about Inupiat youth suicide and its prevention. _International
Journal of Circumpolar Health_, 65(5), 448-458.
Objectives. To better understand youth and adult community members'
perceived causes and possible preventative steps to address the high
Inupiat youth suicide rates in Northwest Alaska. Study Design. A
five-item, open-ended survey focusing on community members' perceptions
of suicide causes, warning signs, and protective factors was
administered in the twelve Native villages served by the Maniilaq
Association, a native non-profit organization. Methods. A total of 382
surveys were completed. Qualitative answers were assigned to categories
by two reviewers. Main categories are described reflecting the
percentages of all response categories and those of youth and adult
respondents. To discern whether the difference in proportion between
adult and youth respondents was significant, a two-tailed z test was
used to compare the two category proportions with their respective
sample sizes. Results. The results showed that villagers believe that a
community-based approach is most beneficial. Many risk factors for
suicide were associated with alienation, and prevention strategies were
linked to increased communication and connection with others, their
culture and spirituality. The results also show that different
perspectives are held by adults and youth. Adult respondents identified
boredom as the primary reason for suicide. This-according to adult
survey responses-can be addressed through programs offering young people
activities, education, and a sense of culture. In contrast, the majority
of young people attribute suicide to stress. The young respondents
answers highlight the need for adults to talk to them about their
everyday lives and their futures so that they receive the guidance and
support they need to navigate difficulties that arise. Conclusions.
These differing, adult and youth conceptions of youth suicide prevention
need to be aligned in order to create effective youth suicide prevention
strategies for Inupiat and other Native populations.
Helena de Moura Castro
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