scholarly journals Recruiting and Engaging American Indian and Alaska Native Teens and Young Adults in a SMS Help-Seeking Intervention: Lessons Learned from the BRAVE Study

2020 ◽  
Vol 17 (24) ◽  
pp. 9437
Author(s):  
David Stephens ◽  
Roger Peterson ◽  
Michelle Singer ◽  
Jacqueline Johnson ◽  
Stephanie Craig Rushing ◽  
...  
Keyword(s):  
Social Media ◽  
Young Adults ◽  
American Indian ◽  
Alaska Native ◽  
Help Seeking ◽  
Text Messages ◽  
Lessons Learned ◽  
Health Board ◽  
Science Technology ◽  
Media Channels

This paper shares lessons learned recruiting and engaging participants in the BRAVE study, a randomized controlled trial carried out by the Northwest Portland Area Indian Health Board and the mHealth Impact Lab. The team recruited 2330 American Indian/Alaska Native (AI/AN) teens and young adults nationwide (15–24 years old) via social media channels and text message and enrolled 1030 to participate in the 9 month study. Teens and young adults who enrolled in this study received either: 8 weeks of BRAVE text messages designed to improve mental health, help-seeking skills, and promote cultural pride and resilience; or 8 weeks of Science Technology Engineering and Math (STEM) text messages, designed to elevate and re-affirm Native voices in science, technology, engineering, math and medicine; and then received the other set of messages. Results indicate that social media channels like Facebook and Instagram can be used to recruit AI/AN teens and young adults. Retention in this study was high, with 87% of participants completing both the BRAVE and STEM intervention arms. Lessons learned from this process may help teen and young adult-serving organizations, prevention programs, policy makers, researchers, and educators as they support the next generation of AI/AN change makers.

Efficacy and Impact of an mHealth Intervention to promote Mental Wellness for American Indian and Alaska Native Teens and Young Adults: A Randomized Controlled Trial of the BRAVE Study (Preprint)

2020 ◽  
Author(s):  
Stephanie Craig Rushing ◽  
Allyson Kelley ◽  
Sheana Bull ◽  
David Stephens ◽  
Julia Wrobel ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Young Adults ◽  
Alaska Native ◽  
Help Seeking ◽  
Culturally Relevant ◽  
Controlled Trial ◽  
Text Message ◽  
Text Messages ◽  
Randomized Controlled ◽  
Mental Wellness

BACKGROUND Culturally-relevant interventions are needed to help American Indian and Alaska Native (AI/AN) teens and young adults navigate common risky situations involving family and friends, including drug and alcohol misuse, dating violence, and suicidality. We R Native – a multimedia health resource for Native teens and young adults – designed an intervention for Native youth, delivered via text message, that includes role model videos, mental wellness strategies, and links to culturally-relevant resources (hotlines, chat-lines, websites, etc.) and social support. OBJECTIVE This study aims to test the efficacy of BRAVE to improve participant’s physical, mental, and spiritual health, their use of mental wellness strategies, their help-seeking skills, and associated factors, including cultural resilience, identity, and cultural pride. METHODS The randomized controlled trial was carried out by the Northwest Portland Area Indian Health Board and the mHealth Impact Lab. The team recruited 2,334 AI/AN teens and young adults nationwide (15-24 years old) via social media channels and text message and enrolled 1,044 to participate. AI/AN teens and young adults enrolled in the study received either: 8 weeks of BRAVE text messages designed to improve mental health, help-seeking skills, and cultural resilience; or 8 weeks of STEM text messages, designed to elevate and re-affirm Native voices in science, technology, engineering, math and medicine (STEM); and then received the other set of messages. Primary and secondary outcomes were tested using linear mixed-effect models and linear regressions. RESULTS A total of 833 AI/AN teens and young adults were included in the analysis. Individuals in the BRAVE and STEM arms showed significant positive trends over the course of the study for all primary outcomes except cultural identity and help seeking behavior. Mean scores were significantly different for health (P<.001), resilience (P<.001), negative coping (P=.027), positive coping (P<.001), self-efficacy (P=.021), and self-esteem (P<.001). Changes in help-seeking self-efficacy were significant for those exhibiting risky behavior at baseline to exit (P=.01). Those who reported positive coping scores at baseline also reported better health on average, but no difference in risky drug and alcohol use (P<.001). The number of participants that used text messages to help themselves increased from 69% at 3-months (427/618) to 75% at 8-months (381/501) (P<.001). Similarly, the number of participants that used text messages to help a friend or family member increased from 22% at 3-months (138/616) to 55% at 8-months (272/498). CONCLUSIONS This is the first nationwide randomized controlled trial for AI/AN teens and young adults to test the efficacy of an mHealth intervention on mental wellness. The findings suggest that culturally-relevant multimedia, mHealth interventions can improve help-seeking behavior. Lessons learned from this study may help other AI/AN-serving organizations, prevention programs, policymakers, researchers, and educators as they support the next generation of AI/AN change-makers.

Patterns of User Engagement in the BRAVE Study (Preprint)

2021 ◽  
Author(s):  
Julia Wrobel ◽  
Joshva Silvasstar ◽  
Roger Peterson ◽  
Kanku Sumbundu ◽  
Allyson Kelley ◽  
...  
Keyword(s):  
Young Adults ◽  
Alaska Native ◽  
Help Seeking ◽  
Role Model ◽  
Text Message ◽  
Poor Mental Health ◽  
Text Messages ◽  
User Engagement ◽  
Mhealth Intervention ◽  
The Impact

BACKGROUND Many American Indian and Alaska Native (AI/AN or Native) communities express concern about high rates of suicide and poor mental health. Technology-based health interventions that nurture resilience, coping skills, connectedness and help-seeking skills may be an effective strategy for promoting health and wellbeing for AI/AN youth. OBJECTIVE This study explored system data from the BRAVE intervention to determine patterns of user engagement. METHODS The BRAVE study included 1,030 AI/AN teens and young adults nationwide (15-24 years old). The message series in the BRAVE and STEM study arms included 3–5 text messages per week, featuring 1 role model video and 1 image per week. Messages were sent out via Mobile Commons, a mobile messaging provider that supports text, picture, and video SMS. This study utilized two sets of data. The first dataset included 23,004 records of messages sent teens and young adults and 874 records of messages clicked with time stamp and content. The second dataset was created by aggregating the clicks in the first dataset to calculate a total number of clicks for each user. RESULTS Of the 509 participants in the original BRAVE analysis, 270 had sufficient data to analyze user engagement, with at least one trackable click on a study text message. Of these, 68% were female (n = 184), 19% were male (n = 50), and 13% selected another gender category (n = 36). The average participant was 20.6 years-old, with a minimum and maximum of 15 and 26 years. Most participants had relatively low engagement measured by the number of clicks (median 2, mean 3.4), while others clicked message content as many as 49 times. Users engaged most frequently with the YouTube-based content (viewing one of 7 role model videos), with 64.8% of total clicks coming from the role model videos, and earlier episodes seeing the highest number of clicks. Most baseline psychosocial measures were not significantly associated with the number of links clicked. However, help-seeking behavior was highly significant (P<.001), with a rate ratio of 0.82 (0.73, 0.92), indicating that each one-unit increase in help-seeking score at baseline was associated with an 18% decrease in the expected number of study clicks. CONCLUSIONS This is the first study to set initial standards for assessing user engagement in an mHealth intervention. Our work underscores the feasibility of exploring the impact of engagement on intended outcomes, allowing for more precise exploration of the dose-response relationship that may be realized through these low-touch interventions that offer promising potential for reaching high numbers of program participants. CLINICALTRIAL 1384639

scholarly journals Messaging for Interventions Aiming to Improve Calcium Intake in Young Adults—A Mixed Methods Study

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1673 ◽  
Author(s):  
Anika Rouf ◽  
Margaret Allman-Farinelli
Keyword(s):  
Social Media ◽  
Young Adults ◽  
Calcium Intake ◽  
Daily Intake ◽  
Text Messages ◽  
Cross Sectional ◽  
Web Based ◽  
Significant Difference ◽  
Awareness Raising ◽  
Media Channels

Social media channels are the preferred communication tools for many young adults and therefore may have applications in health promotion. The framing of messages is important, as an intervention must resonate with the target group. The aim of this study was to determine what type of messaging is preferred by young adults to improve their calcium intake. A cross-sectional web-based survey was conducted and young adults aged 18 to 25 years recruited. A 14-item survey collected information on the participants’ demographics, ranking of text messages, mock Facebook posts with images, preferences related to type of posts they find personally relevant, and frequency and likelihood of engagement with posts and polls in social media. In addition, optional responses from participants about factors that motivate them to consume more calcium-rich foods were included and thematically analysed using NVivo. Eighty-one participants (17 males) completed the survey. No significant difference in ranking of the text messages and Facebook posts were found. Participants indicated that recipe demonstrations (n = 71), cost-saving tips (n = 70), and information on recommended daily intake (n = 62) were personally relevant, while meal inspiration (n = 70), awareness-raising posts (n = 41), and messages about obtaining enough calcium from non-dairy sources (n = 38) would encourage them to eat more calcium-rich foods. The qualitative replies indicated the tone (in young adults’ language) and length (short) of messages preferred, and the messaging they perceived would motivate young adults. In conclusion, short, aesthetically pleasing and personally relevant messages written in the language of young adults were recommended.

Dealing With the Risks of Information Overload

2021 ◽  
pp. 267-293
Author(s):  
Vincent P. Magnini ◽  
Erika Quendler
Keyword(s):  
Social Media ◽  
Information Overload ◽  
Text Messages ◽  
Family Farms ◽  
Script Theory ◽  
Modern Information ◽  
Media Channels ◽  
On Farm ◽  
Tuning Out ◽  
Research Recommendations

While guests go on farm holidays in the hope of receiving authentic and memorable experiences, information overload is a factor that is increasingly detracting from such experiences. For instance, the steady stream of emails, text messages, and news received through social media channels tends to distract from the main experience. To cope with such overload, script theory suggests that guests are increasingly ‘satisficing' their information intake and subconsciously tuning-out much incoming stimuli from their surroundings. This subconscious satisficing makes it more difficult for farm holiday providers to win the guest's full attention in order to create memorable and authentic experiences. Therefore, this chapter synthesizes theories and empirical research from several disciplines with a view to gaining a better understanding of how this modern information overload serves as a formidable threat to farm holiday providers, who typically operate from small family farms. This synthesis is then employed as the basis for a number of practical and research recommendations.

scholarly journals Drawing from justice theories to support targets of online harassment

2020 ◽  
pp. 146144482091312
Author(s):  
Sarita Schoenebeck ◽  
Oliver L Haimson ◽  
Lisa Nakamura
Keyword(s):  
United States ◽  
Social Media ◽  
Criminal Justice ◽  
American Indian ◽  
Alaska Native ◽  
Online Survey ◽  
The United States ◽  
Online Harassment ◽  
Justice Theories

Most content moderation approaches in the United States rely on criminal justice models that sanction offenders via content removal or user bans. However, these models write the online harassment targets out of the justice-seeking process. Via an online survey with US participants ( N = 573), this research draws from justice theories to investigate approaches for supporting targets of online harassment. We uncover preferences for banning offenders, removing content, and apologies, but aversion to mediation and adjusting targets’ audiences. Preferences vary by identities (e.g. transgender participants on average find more exposure to be undesirable; American Indian or Alaska Native participants on average find payment to be unfair) and by social media behaviors (e.g. Instagram users report payment as just and fair). Our results suggest that a one-size-fits-all approach will fail some users while privileging others. We propose a broader theoretical and empirical landscape for supporting online harassment targets.

scholarly journals LISTENING AND LEARNING TO FORM THE HBI ROAD MAP FOR INDIAN COUNTRY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S366-S366
Author(s):  
Molly French ◽  
Michael Splaine ◽  
John Shean ◽  
Heidi Holt
Keyword(s):  
Alaska Native ◽  
International Association ◽  
Lessons Learned ◽  
Health Board ◽  
Government Officials ◽  
Tribal Government ◽  
Road Map ◽  
Indian Country ◽  
Control And Prevention ◽  
Public Health Strategies

Abstract American Indian and Alaska Native (AI/AN) communities are establishing new paths as more older adults develop Alzheimer’s and other dementias along with other co-morbidities. To offer a flexible framework of public health strategies that proactively address the growing issue of dementia among AI/ANs, Alzheimer’s Association and Centers for Disease Control and Prevention (CDC) developed the first-ever Healthy Brain Initiative Road Map for Indian Country. Partnering with International Association for Indigenous Aging supported Road Map development through virtual listening sessions and written comments from regional Native health experts, tribal aging service leaders, and tribal government officials. Many additional discussions, engagement of a cultural guide, and an additional partnership with National Indian Health Board further informed Road Map contents, graphic design, and marketing. Presenter will describe rationale for the process, themes from the consultations, and lessons learned by the Association and CDC that can apply to similar initiatives.

scholarly journals Trends in Diabetes Prevalence Among American Indian and Alaska Native Children, Adolescents, and Young Adults

2002 ◽  
Vol 92 (9) ◽  
pp. 1485-1490 ◽  
Author(s):  
Kelly J. Acton ◽  
Nilka Ríos Burrows ◽  
Kelly Moore ◽  
Linda Querec ◽  
Linda S. Geiss ◽  
...  
Keyword(s):  
Young Adults ◽  
American Indian ◽  
Alaska Native ◽  
Adolescents And Young Adults ◽  
Diabetes Prevalence

scholarly journals Improving Calcium Knowledge and Intake in Young Adults Via Social Media and Text Messages: Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Anika Rouf ◽  
Monica Nour ◽  
Margaret Allman-Farinelli
Keyword(s):  
Social Media ◽  
Randomized Controlled Trial ◽  
Young Adults ◽  
Calcium Intake ◽  
Text Messaging ◽  
Habit Formation ◽  
Controlled Trial ◽  
Text Messages ◽  
Control Group ◽  
Randomized Controlled

BACKGROUND Calcium is an important nutrient for the attainment of peak bone mass during adolescence and young adulthood. However, these life phases are characterized as hard to reach for health promotion. Social media platforms offer a promising channel as they are relatively low cost but used ubiquitously by youth. OBJECTIVE The aim of the CAlcium Nutrition-Dietary Opportunities (CAN-DO) study was to conduct a randomized controlled trial to test the effectiveness of Facebook alone or with text messaging as channels to deliver a theory-based program to encourage optimal calcium intake. METHODS The intervention was a 3-arm parallel trial. Young adults aged 18 to 25 years were recruited through university and social media for a 6-week trial. Participants were randomized to 1 of the 3 arms (ie, Facebook posts, Facebook posts plus text messages, and control group that received an electronic leaflet containing information on calcium intake). The primary outcome was change in intake of milk and other calcium-rich foods, and secondary outcomes were knowledge, self-efficacy, motivation, and habit formation concerning calcium-rich foods. Changes were assessed before and after the intervention, and the differences in change between groups were compared using multivariate regression models with multiple imputations for missing data. RESULTS A total of 211 participants (64/211, 30.3% males) participated (mean age 21.4 years, SD 2.1) in this study. At the end of the program, no increase in milk intake (odds ratio [OR] 1.51, 95% CI 0.61-3.75 Facebook; OR 1.77, 95% CI 0.74-4.24 Facebook plus text messages; <i>P</i>=.41) nor calcium-rich food was detected (<i>P</i>=.57). There was a significant improvement in knowledge in the Facebook plus text messages group (<i>P</i>&lt;.001), but habit formation improved less than that in the other 2 groups (<i>P</i>=.01). Our results showed a moderate level of engagement with intervention content and positive qualitative feedback from participants. CONCLUSIONS The CAN-DO study delivered via Facebook (with the additional support of text messages) was found to improve knowledge and was acceptable among young adults. However, further research is needed to better understand social media engagement and how to optimize the program for participants to be sufficiently motivated to increase their intake of calcium-rich foods. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12620000097943; http://www.anzctr.org.au/ACTRN12620000097943.aspx

scholarly journals Sharing Lessons Learned from Beta-Testing the CAN Quit Facebook Group Prototype to Promote Smoking Treatment Utilization among Alaska Native People (Preprint)

2021 ◽  
Author(s):  
Pamela S Sinicrope ◽  
Colleen Young ◽  
Ken Resnicow ◽  
Zoe T Merritt ◽  
Clara R McConnell ◽  
...  
Keyword(s):  
Social Media ◽  
Smoking Cessation ◽  
Native American ◽  
Alaska Native ◽  
Lessons Learned ◽  
Native People ◽  
Evidence Based ◽  
American Indian People ◽  
Beta Testing ◽  
Group Engagement

UNSTRUCTURED Social media presents an effective tool to reach, engage, and connect smokers in cessation efforts. Our team developed the Facebook group, CAN Quit (Connecting Alaska Native People to Quit smoking), to promote utilization of evidence-based smoking cessation resources for Alaska Native (AN) people living in Alaska, which are underutilized despite their effectiveness. Often separated by geography and climate, AN people prefer group-based approaches for tobacco cessation that support their culture and values. Such preferences make AN people candidates for social-media-based interventions which promote connection. This Viewpoint discusses the steps involved and lessons learned in building and beta-testing our Facebook (FB) group prototype. We describe the process of training moderators to facilitate group engagement and foster community and we describe how we developed and beta tested our intervention prototype and FB group. All parts of the prototype are designed to facilitate utilization of evidence-based cessation treatments. We include recommendations for best practices with the hope that lessons learned from the CAN Quit prototype could provide a model for others to create similar platforms that benefit Alaska Native / American Indian people in the context of smoking cessation.

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