Translating RESPECT with American Indian and Alaska Native Communities
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Description
This project provided the means to assess the appropriateness of an evidence-based HIV-prevention intervention among American Indian and Alaska Native (AI/AN) communities. The intervention, RESPECT, has been shown to reduce the incidence of sexually transmitted diseases (STDs) and risky sexual behavior in other settings. It had not been used in AI/AN communities, however. Because rates of STDs are significantly higher in Native populations compared to national levels—especially among youth—and because of the links of STDs to HIV, successful intervention is critical. This project sought to provide a model of intervention in an American Indian community, develop a culturally responsive dissemination plan, and assess how communities adopt the intervention.
Partners
- Oglala Lakota Sioux Tribe
- Pine Ridge Indian Health Service
- Kyle High School
- Oglala Sioux Wellness Team
- Denver Prevention Training Center
- National Native American AIDS Center for Prevention
Specific aims
- With tribal partnerships, regional alliances, and national collaboration, use the Theory of Diffusion of Innovations to guide the development of a dissemination plan for RESPECT with AI/AN communities.
- Using the RE-AIM framework of enhancing external validity, implement the RESPECT intervention in school-based clinics in a specific AI community.
- Evaluate the potential diffusion of RESPECT based on the results of 1 and 2.
Outcomes
Overall, we received tremendous support for our project from community partners, and nationally, survey responses indicated support for an adaptation of a risk reduction intervention for AIAN communities. Our experience in implementation revealed several key factors in successful implementation: [1] Identification of adequate space – often a premium in reservation-based schools – is critical to assure confidentiality, privacy, and reliable schedules; [2] youth, regardless of sexual activity, sought out our services, anxious for information and guidance on sexual health, and [3] establishing a local, responsive referral system was critical since youth commonly reported problems or challenges needing address but outside the project’s purview.
Over the course of the project, our staff:
- Conducted over 24 classroom presentations.
- Participated in 27 community health fairs or other community events, reaching hundreds of youth and community members in this way.
- Met personally with over 200 parents during school registration weeks.
- In partnership with tribal programs, tested over 900 individuals for HIV.
- Provided a regional training on RESPECT and its translation and implementation for AIAN communities.
Publications/presentations
“Translating RESPECT with Native Communities: Preliminary Observations” STI/HIV Behavioral Research Group, Denver Public Health, Denver, CO, October 27, 2010
“Project RESPECT: Using an Evidence-Based HIV-Prevention Intervention in Native Communities” Oglala Sioux Tribe Research Conference, Kyle, SD, August 2, 2011.
“Sexual Risk and Native Youth: Project RESPECT,” Social and Behavioral Factors in Health, Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Denver, November, 17, 2011.
Kaufman, C.E., Keane, E.M., Shangreau, C., Arthur-Asmah, R., Morse, B., & Whitesell, N.R. (2018). Dissemination and uptake of HIV/STD preventive interventions in American Indian and Alaska Native Communities: A case study. Ethnicity & Health. Online (August). doi: 10.1080/13557858.2018.1514456