Logo for Native WYSE Choices (Women Young Strong Empowered)

Fetal Alcohol Spectrum Disorders (FASD) result in neurodevelopmental deficits and lifelong disability; they are a leading cause of preventable birth defects in the U.S. According to the CDC, any sexually active woman of reproductive age who drinks alcohol and does not use effective contraception is at risk for an alcohol exposed pregnancy (AEP) that could cause FASD. By this definition, American Indian and Alaska Native (AI/AN) young women are especially vulnerable to AEP, with high levels of alcohol consumption and sexual risk taking compared to their counterparts in other race/ethnic groups. Although an estimated 72% of AI/AN young women live in urban areas, very little research has yet included them; urban AI/AN needs are often ignored in research aimed at developing, implementing, and evaluating culturally appropriate services. Recent research indicates that mobile health (mHealth) interventions may offer a promising mechanism for delivering effective interventions to hard-to-reach populations.

Program overview

The goal of Native WYSE CHOICES (women, young, strong, empowered) is to expand reach and services to urban AI/AN young women through mHealth technology to prevent AEP and FASD. The project builds on a prior NIAAA-funded project which used intensive community-based participatory research (CBPR) methods to adapt CHOICES, an evidence-based brief AEP intervention supported by the CDC, to American Indian Youth CHOICES (AIY-C). AIY-C contains features that make it highly amenable to mHealth approaches, including a framework for integrating diverse cultural teachings, few modules of short duration, and concrete opportunities for goal-setting and achievement. Innovative for this population is the plan to recruit young AI/AN women from major urban areas in the U.S. through social media, and to deliver the translated intervention – Native WYSE (women young strong empowered) CHOICES – via mobile devices, increasingly ubiquitous among AI/AN young adults. While social media recruitment and mHealth interventions are not new, only very recently have they been used with AI/AN populations.

We are partnering with urban AI/AN organizations to guide us through social media recruitment strategies, mHealth intervention translation and implementation, and evaluation in urban AI/AN settings. The proposed project promises expansive reach to AI/AN young women to address significant yet preventable public health concerns – AEP and FASD. Importantly, the project also promises to advance a blueprint for preventive intervention research with urban AI/AN populations largely ignored to date. 




Specific aims

  1. Develop and pilot social-media-based recruitment strategies for urban AI/AN young women. 
  2. Translate AIY-C for mHealth delivery through an iterative and theoretically driven process and pilot the developed translated mHealth intervention – Native WYSE CHOICES.
  3. Recruit urban AI/AN young women using identified social media strategies, and conduct an randomized controlled trial to rigorously evaluate the effectiveness of the Native WYSE CHOICES App for preventing AEP and FASD. 


Outcomes (in process)

  • Urban Community Advisory Board Meetings (2-3 times annually)
  • Data Safety and Monitoring Board review (semi-annual)
  • Clinical Trials registration
  • App development (in process)

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