The Affordable Care Act provides funding for home-visiting programs to reduce health care disparities, despite limited evidence that existing can overcome implementation and evaluation challenges with at-risk populations. authors report 36-month outcomes of the paraprofessional-delivered Family Spirit intervention American Indian teen mothers children.Expectant teens (N=322, mean age=18.1 years) from four southwestern reservation communities were randomly assigned plus optimized standard or...

We examined suicide and attempt rates, patterns, risk factors among White Mountain Apache youths (aged < 25 years) from 2001 to 2006 as the first phase of a community-based participatory research process design evaluate prevention interventions.

The National Strategy for Suicide Prevention highlights the importance of improving timeliness, usefulness, and quality national suicide surveillance systems, expanding local capacity to collect relevant data. This article describes background, methods, process data, implications from first-of-its-kind community-based system suicidal self-injurious behavior developed by White Mountain Apache Tribe with assistance Johns Hopkins University. enables local, detailed, real-time data collection...

Objectives. We evaluated the impact of a comprehensive, multitiered youth suicide prevention program among White Mountain Apache Arizona since its implementation in 2006. Methods. Using data from tribally mandated Celebrating Life surveillance system, we compared rates, numbers, and characteristics deaths attempts 2007 to 2012 with those 2001 Results. The overall death rates dropped 40.0 24.7 per 100 000 (38.3% decrease), rate aged 15 24 years 128.5 99.0 (23.0% decrease). annual number also...

Highlights This study is only one of few that describe the development a ground up prevention intervention. process can be replicated by other tribes to promote cultural beliefs, traditions and language. The Elders’ Curriculum an intergenerational approach taps community strengths.

<h3>Objective</h3> To assess the impact of a paraprofessional-delivered home-visiting intervention to promote child care knowledge, skills, and involvement among pregnant American Indian adolescents. <h3>Design</h3> Randomized controlled trial comparing family-strengthening with breastfeeding education program. <h3>Setting</h3> One Apache 3 Navajo communities. <h3>Participants</h3> Fifty-three adolescents were randomly assigned (n = 28) or control 25) groups. Follow-up data available for 19...

American Indian communities compared to other US populations are challenged by the largest health disparities in substance abuse and suicidal behavior among youth ages 15-24.This article examines co-occurrence of use self-injury reservation-based US.White Mountain Apache tribal leaders Johns Hopkins University formed a partnership address youth. Data on suicide (deaths, attempts, ideation), non-suicidal self-injury, were analyzed from White tribally mandated surveillance registry 2007 2010,...

American Indian adolescents are at disproportionate risk for suicide, and community-based studies of this population, which allow a deeper understanding risks resilience to inform interventions, rare. This is cross-sectional study N = 71 Apache adolescents. Strengths include the role community paraprofessionals in design, implementation, interpretation findings. Participants were M 16.0 years old, 65% female, 69% multiple attempters. Risks included suicidal behavior among peers family (68%),...

Artificial intelligence and machine learning (AI/ML) in prevention science may improve or perpetuate health inequities. Community engagement is one proposed strategy thought to empirically mitigate bias AI/ML tools. We outline how incorporate community at every stage of the model development implementation. Borrowing from a framework for phases research, we describe value application engaging communities help shape more rigorous relevant applications science. provide concrete examples...

Native American (Native) adolescents have the highest suicide rates in United States, yet no conceptual models describing risk factors specific to this population exist. We sought further hone a Native-specific model developed from quantitative data with qualitative collected longitudinal series of interviews ( N = 22) who had attempted suicide. Four levels emerged, detailing individual, family, community, and societal that affect youths’ pathways suicide, along variety subthemes constructs....

Background: American Indian (AI) adolescents are disproportionately burdened by alcohol abuse and heavy binge use, often leading to problematic drinking in adulthood. However, many AI communities also have large proportions of adults who abstain from alcohol. Objective: To understand these concurrent divergent patterns, we explored the relationship between risk protective factors for use among a reservation-based sample adolescents. Methods: Factors at individual, peer, family,...

Native American populations experience a substantial burden of pneumococcal disease despite use highly effective conjugate vaccines (PCVs). Protein-based may extend protection beyond the serotype-specific elicited by PCVs.In this phase IIb, double-blind, controlled trial, 6-12 weeks-old infants randomized 1:1, received either protein-based vaccine (dPly/PhtD) containing pneumolysin toxoid (dPly, 10 µg) and histidine triad protein D (PhtD, or placebo, administered along with 13-valent PCV...

In the United States, introduction of heptavalent pneumococcal conjugate vaccine (PCV) largely eliminated serotypes (VT); non-vaccine (NVT) subsequently increased in carriage and disease. Vaccination also disrupts composition pangenome, which includes mobile genetic elements polymorphic non-capsular antigens important for virulence, transmission, ecology. Antigenic proteins are interest future vaccines; yet, little is known about how they affected by PCV use. To investigate evolutionary...

Few suicide risk identification tools have been developed specifically for American Indian and Alaska Native populations, even though these populations face the starkest suicide-related inequities.

Previous literature is severely limited in evaluation of psychometric properties suicide screening methods American Indian (AI) populations, despite the disproportionate burden faced within AI communities. The purpose current study was to examine Suicidal Ideation Questionnaire-Junior (SIQ-JR) for youth using 2 community samples adolescents from a Southwestern tribe. present sample comprised 114 participants (n = 91 and n 23), ages 10-19 years age, studies, both which were administered...

Background: Entrepreneurship education has demonstrated positive impacts in low-resource contexts. However, there is limited evidence of such programs evaluated among Native American (NA) youth a rural reservation. Methods: A 2:1 randomized controlled trial the impact Arrowhead Business Group (ABG) entrepreneurship program on knowledge, economic empowerment, and social well-being 394 NA youth. An intent to treat analysis using mixed effects regression models examined within between study...

Introduction: American Indian (AI) youth experience poor sexual health outcomes. Research indicates the Protection Motivation Theory (PMT) is a robust model for understanding how risk and protective behaviors are associated with condom use intention (CUI). Studies indicate constructs of PMT which influence CUI vary by sex experience. This analysis explores associations between among AI who participated in Respecting Circle Life (RCL) trial, reproductive intervention. Methods: We analyzed...

Objective Suicide prevention is a major priority in Native American communities. We used machine learning with community‐based suicide surveillance data to better identify those most at risk. Method This study leverages from the Celebrating Life program operated by White Mountain Apache Tribe Arizona and partnership Johns Hopkins University. examined N = 2,390 individuals validated suicide‐related event between 2006 2017. Predictors included 73 variables (e.g., demographics, educational...

Abstract Background This study is built on a long-standing research partnership between the Johns Hopkins Center for American Indian Health and White Mountain Apache Tribe to identify effective interventions prevent suicide promote resilience among (AI) youth. The work founded tribally-mandated, community-based surveillance system with case management by local community mental health specialists (CMHSs) who strive connect at-risk youth treatment brief, adjunctive piloted in past research....

Several Streptococcus pneumoniae proteins play a role in pathogenesis and are being investigated as vaccine targets. It is largely unknown whether naturally acquired antibodies reduce the risk of colonization with strains expressing particular antigenic variant.Serum immunoglobulin G (IgG) titers to 28 pneumococcal protein antigens were measured among 242 individuals aged <6 months-78 years Native American communities between 2007 2009. Nasopharyngeal swabs collected >- 30 days after serum...