47. Cultural Connection and Mental Health for American Indian Adolescents

ABSTRACT

Purpose: American Indian and Alaska Native (AI/AN) adolescents face significant physical and mental health disparities. These inequities result from historical and intergenerational traumas, which are the cumulative, permeating effects that impact individuals and communities who share a specific identity. Currently there is a paucity of research focusing on the mental health of AI/AN youth as well as the relationship between mental health and cultural connection. This project assesses the relationship between cultural identity (ethnic identity and tribal affiliation) and outcomes associated with mental health (loneliness, friendships, emotional support, and sleep) for AI/AN adolescents. It also aims to understand the impact of the COVID-19 pandemic on stress management for AI/AN adolescents. Methods: 12 to 18 year old adolescents from the Lumbee Tribe of North Carolina participated in this mixed-methods study. The project involved two phases informed by the principles of community-based participatory research. Phase 1, discussed in this , involved surveys using validated instruments to assess cultural connection, mental health outcomes, stress management, and resilience among participants. Phase 2 involves semi-structured interviews with adolescents. Results: Of 123 AI/AN youth who completed the survey, 54.5% (N=67) were 15-18 years old with mean age of 14.9 (SD=2.0). 61% (N=75) were assigned female at birth, 56% (N=70) identified as female, and 4.1% (N=5) identified as non-binary. Mean tribal affiliation (TA) and ethnic identity (EI) scores suggest strong cultural connection among participants (TA mean 3.1/5, SD 0.6;EI 3.4/5, SD 0.9). Sleep quality (mean 2.63/5) and positive stress management (mean 2.06/5) were low, suggesting room for improvement. Bivariate analysis and logistic regressions demonstrated moderate positive correlations between ethnic identity and friendship, ethnic identity and emotional support, tribal affiliation and friendship, and tribal affiliation and emotional support. Conclusions: Results highlight that AI/AN adolescents in this sample have a moderate-strong connection with culture, marked by ethnic identity and tribal affiliation. They also demonstrate the impact of cultural connection on mental health for AI/AN adolescents. Phase 2 will draw upon Phase 1 findings to further understand the relationship between cultural connection and mental health outcomes, and to promote community-driven interventions emphasizing inherent strengths and resiliencies identified through qualitative interviews of AI/AN youth. Data related to cultural connection and mental health outcomes may also be used to set the framework for policy formulation which may allow for increased funding and programming addressing mental health for AI/AN youth. Sources of Support This research received support from the UNC Chapel Hill Office of Global Health.