Rates of Recent Adverse Childhood Experiences Among Indigenous Children.

The current paper describes rates of recent (past six months) adverse childhood experiences (ACEs) and examines the association of ACEs with cultural connection and depressive symptoms among Indigenous children aged 10 to 14 (N = 177; mean age = 11.8; 48.3% boys; 44.3% girls; 7.4% another gender identity). Children completed baseline surveys as part of a larger evaluation of a culturally grounded, strengths-focused, family-based program to prevent ACEs. Surveys included an inclusive measure of ACEs developed for the current study, an adapted measure of connection to culture, and the Children's Depression Screener. Results for ACEs indicated that 18.6% of Indigenous children reported none, 37.2% reported one to three, and 44.2% reported four or more in the past six months. Importantly, children who reported no ACEs reported greater cultural connection than children who reported one to three ACEs. Depressive symptoms were higher among children who reported one to three and four or more ACEs compared to children who reported no ACEs.

Rates and Correlates of Intimate Partner Abuse Among Indigenous Women Caregivers.

Intimate partner abuse (IPA) is a public health crisis that disproportionately impacts indigenous women. We know little about rates and correlates of IPA victimization (IPAV) and abuse directed at one's partner (ADP) among indigenous women caregivers (people who take care of children). The purpose of the current study was to address this critical gap in the literature. Participants were 44 indigenous women caregivers in the United States in a current relationship who completed a survey. Most women reported IPAV and ADP experiences in the past 6 months, and IPAV and ADP abuse directed at partner were positively associated. Further, IPAV was positively associated with adverse childhood experiences (ACEs), participants' engagement in harsh parenting, and depressive symptoms. IPAV was negatively associated with age, income, indigenous cultural identity, and social support. ADP was positively associated with ACEs, harsh parenting, and depressive symptoms. ADP was negatively associated with age and income. ADP was not associated with indigenous cultural identity and social support. These data suggest the urgency with which efforts are needed to prevent and respond to IPA among indigenous women caregivers, especially those who are younger and of lower income, and that culturally grounded initiatives that seek to build social support may be especially impactful.

Indigenous Cultural Identity Protects Against Intergenerational Transmission of ACEs Among Indigenous Caregivers and Their Children.

A large body of empirical research has demonstrated that caregiver adverse childhood experiences (ACEs) predict ACEs in one's child, a phenomenon known as the intergenerational transmission of ACEs. Little of this empirical research, however, has focused specifically on Indigenous peoples despite a growing body of theoretical literature and the wisdom of Elders and Traditional Knowledge Keepers that speaks to the presence of this phenomenon within Indigenous communities as well as the protective role of Indigenous cultural identity in preventing the intergenerational transmission of ACEs. The purpose of the current study was to conduct an empirical evaluation of this hypothesis, specifically that Indigenous cultural identity and social support protects against the intergenerational transmission of ACEs among Indigenous peoples and their children in the USA. Participants were 106 Indigenous women caregivers of children ages 10 to 14 in South Dakota who completed surveys. Results showed that Indigenous cultural identity moderated the association between caregiver ACEs and child ACEs. At high levels of cultural identity, there was no association between caregiver ACEs and child ACEs. At low levels of Indigenous cultural identity, however, there was a strong and positive relationship between caregiver ACEs and child ACEs. Social support did not moderate the association between caregiver ACEs and child ACEs. These findings underscore the need for initiatives that enhance Indigenous cultural identity and social support among Indigenous caregivers to prevent the intergenerational transmission of ACEs.

Diffusion effects of a sexual violence prevention program leveraging youth-adult partnerships.

The purpose of the current study was to examine the diffusion effects of a youth-led sexual violence prevention program (i.e., Youth Voices in Prevention [Youth VIP]). Specifically, social network analysis was used to measure the extent to which Youth VIP changed behaviors for 1172 middle and high school youth who did not attend program events but were friends with Youth VIP participants and completed the first and final survey (approximately 2 years apart). Findings suggest that there was considerable interpersonal communication about Youth VIP among the students generated by program participation. Specifically, youth with friends who participated in Youth VIP were more likely to report hearing their friends talk about Youth VIP and reported talking to their friends about Youth VIP compared with those not connected to Youth VIP participants. However, there were no diffusion effects found for behavioral outcomes (i.e., bystander intervention behavior, violence victimization, and perpetration). Given the mixed findings, further research is needed to determine the extent to which youth-led sexual violence prevention initiatives lead to changes in broader community-wide changes in youths' behaviors.

Using intergenerational photovoice to understand family strengths among Native American children and their caregivers.

The purpose of the current study was to examine Native American children and caregivers' perspectives of family and cultural strengths using photovoice and to identify lessons learned from the first-ever implementation of intergenerational photovoice with Native Americans. Participants were Native American, low-income caregivers (n = 6) and their children (n = 12) between the ages of 10 and 15 who participated in six photovoice sessions. The themes that emerged from photos and group discussion included myriad challenges faced by Native American families including exposure to community violence, substance abuse, and criminal offending and incarceration. Themes also emerged that highlighted the strengths of Native families that were used to overcome identified challenges, including religion/spirituality, engagement in traditional cultural practices (e.g., prayer, song, dance), healthy activities (e.g., running, meditation). These data provided foundational information that is currently being used, along with other data, to develop a culturally grounded, strengths-focused, family-based program (Tiwahe Wicagwicayapi [Strengthening/Growing Families in Lakota]) to prevent adverse childhood experiences. We also discuss the challenges of intergenerational photovoice and lessons learned to inform future intergenerational photovoice projects.

Engaging Native American Youth and Their Caregivers in Sexual Violence Research: A Case Study Documenting Challenges, Opportunities, and Lessons Learned.

Native Americans (the preferred term of our partners/co-authors) experience high rates of sexual violence, which is rooted in colonization and multiple historical traumas. Sexual violence leads to numerous deleterious outcomes, underscoring the critical need for prevention early in life. Yet, most research to date on sexual violence has not focused on Native American populations, and we know little about the most effective strategies to recruit and retain Native American individuals in sexual violence prevention research. The purpose of the current study, grounded in principles of participatory action research, is to describe strategies that were used to recruit (e.g., traditional feeds, door knocking) and retain (e.g., monetary incentives, ongoing community engagement) Native American youth for a study that sought to assess, via surveys and qualitative interviews, the impacts of a youth-led sexual violence prevention initiative in a small city in the Great Plains. We also collected qualitative data from Native American caregivers regarding their perceptions of research. Overall, 67.9% (n = 545) of eligible Native American youth completed the survey, and school and door knocking were most effective methods of recruitment/enrollment followed by community and school events and texting. Over the course of 3 years of data collection, there were higher rates of attrition among Native American youth compared to white youth, and several factors (e.g., older age, sexual assault victimization) predicted attrition among Native American youth. Native American caregivers' responses reflected on reasons it is hard to engage youth and caregivers in research (e.g., lack of time, distrust) as well as strategies to enhance engagement (e.g., personal connection, providing community resources). Throughout the paper, Native American co-authors and project partners reflect on these findings. Implications for future sexual violence prevention research with Native American youth and their caregivers that uses decolonized, participatory action research methodologies are discussed.

Evaluating the Impact of a Youth-Led Sexual Violence Prevention Program: Youth Leadership Retreat Outcomes.

Involving youth in developing and implementing prevention programs to reduce sexual violence (SV) has the potential to improve prevention outcomes. However, there has been little focus on youth-led SV prevention programs, and limited evaluation research to help guide efforts. The current study examined the effectiveness of Youth Voices in Prevention (Youth VIP) leadership retreats on SV victimization and perpetration, forms of violence related to SV (e.g., bullying), SV bystander behaviors and readiness, and perceptions of norms related to SV prevention. Results identified mixed findings for program impact, with variations in outcomes that can help guide future youth-led prevention program initiatives. Youth attending a large "kick-off" leadership retreat (that was less youth-led that subsequent smaller retreats) later reported more bystander behaviors, but also reported increased perpetration and victimization, compared to non-attending youth. However, youth attending smaller, more focused leadership retreats held during the school year, reported reductions in sexual harassment perpetration and improved bystander behaviors and attitudes compared to non-attending youth. Evaluation of moderator variables suggests that program impact was generally stronger for younger participants, sexual minority youth, and non-White youth (which were largely Native American youth in this sample). Findings suggest promise for youth-led prevention work but also highlight the need for testing the impact of different training structures and modalities. Clinical trials number: NCT03207386.

Attendance at a Community-Based, After School, Youth-Led Sexual Violence Prevention Initiative.

Sexual violence (SV) among adolescents is a pervasive public health concern. Research on community-based prevention programs that seek to reach youth outside of school hours is less developed, but suggests positive effects. In the current paper, we examine attendance at community events and overnight retreats for a youth-led SV prevention initiative, Youth Voices in Prevention (Youth VIP) using survey (n = 2539) and short-answer (n = 1177) data from a broad sample of youth in a small urban district in the Great Plains (United States), where Youth VIP took place. Multivariate logistic regression models using multiple imputation sampling were tested for retreat and community event attendance (respectively). The model of retreat attendance found that those with past SV victimization had significantly higher odds of attending retreats and each additional extracurricular activity youth participated in was associated with increased odds of attendance. The model of event attendance found that male youth had significantly lower odds of attending an event and that odds of attending increased with each additional extracurricular activity reported. Age, race, ethnicity, sexual orientation, and bystander denial were not significant predictors of attendance. Short-answer questions, coded with content analysis, found that youth report being more likely to attend if events feature fun activities with their friends, money, or other incentives; in survey questions, youth report lack of time and lack of interest as the most common reasons for non-attendance. Findings suggest that programming that blends social time and recreational activities with SV content may improve youth attendance; additional recruitment may be needed to engage male youth and youth who are less involved in extracurriculars. This study provides important insight into youth attendance-who attends, who does not, and why-that can be leveraged by others when seeking to engage youth in SV prevention.

Caregivers' Perceptions of a Youth-led Sexual Violence Prevention Initiative: A Brief Report.

Sexual and related forms of violence among middle and high school students are pervasive public health issues, and thus, there is a growing emphasis on the development and evaluation of sexual violence prevention efforts for youth. Caregivers such as parents are important partners in this work as they can facilitate youths' involvement (e.g., give them permission to participate, provide instrumental support such as rides), but their perception of their youth's involvement in sexual violence prevention efforts is largely unexplored. The current paper examined caregivers' perceptions of their teens' participation in a community-wide, out-of-school, youth-led sexual violence prevention initiative. Some caregivers of youth who were involved in the initiative (N = 19; 79.9% White; 21.1% Native American) responded to closed- and open-ended questions about what their teen had talked to them about in relation to the initiative, why their teen participated in the initiative, and how involvement impacted their teen. Furthermore, caregivers who attended events themselves responded to questions about what they learned, what they liked best, and what they liked least. Over half of caregivers said that their teens talked to them about bystander intervention, social emotional skills, and what constitutes sexual violence. Perceptions of the initiative were largely positive both in terms of what the teen learned at part of the programming and in caregivers' own experience participating. These results are promising for the role of caregivers in partners in prevention.

Use of Social Network Analysis to Identify Popular Opinion Leaders for a Youth-Led Sexual Violence Prevention Initiative.

In the current article, we describe an innovative sexual violence (SV) prevention initiative that used social network analysis to identify youth and adult popular opinion leaders who were subsequently trained in best practices in SV prevention (e.g., bystander intervention) at a kickoff event (i.e., camp) of the initiative. We provide information on recruitment strategies, participation rates and how those rates varied by some demographic factors, reasons for nonattendance, the initial impact of the camp, and lessons learned. Despite challenges with youth and adult engagement, this innovative approach has the potential to transform the way we approach SV prevention among youth.

Using photovoice to understand and amplify youth voices to prevent sexual and relationship violence.

AIMS: Efforts to improve prevention of sexual and relationship violence (SRV) among adolescents call for more centering of youth voices, experiences, and skills to design prevention programs that incorporate youth engagement rather than those that are designed by adults for youth. Amplifying the voices of historically marginalized youth are especially needed. Photovoice (PV) is a participatory action method that can empower youth and generate prevention knowledge. METHODS: The current project used PV to engage youth in late middle and early high school to discuss how they could work to prevent SRV in their community. A convenience sample of nine youth (predominately Native American) participated over seven sessions. RESULTS: A key theme they generated is that SRV prevention needs to be viewed as relational. Participants described the complexity of prevention, including how youth need social support to thrive and prevent SRV and that asking for help can be challenging. Results also highlighted that youth can provide help and support, but it is not always welcome in addition to underscoring that youth are resilient and can be prevention leaders. CONCLUSION: Innovations in SRV prevention, especially for older adolescents, should work to engage youth as prevention partners. Participatory research methods like photovoice can be an important part of that process.

Effectiveness of a Sexual Assault Self-defense Program for American Indian Girls.

This study evaluated the effectiveness of a 6-session (12-hour) empowerment self-defense classroom delivered curriculum (i.e., IMpower) among American Indian girls. Girls (N = 74) in one middle school and two high schools on an Indian Reservation in the Great Plains region of the United States received the intervention and completed a pre-test and a post-test six months following the final program session. The surveys administered assessed hypothesized intermediary (i.e., efficacy to resist a sexual assault, self-defense knowledge), primary (i.e., sexual violence victimization), and secondary (i.e., physical dating violence, sexual harassment) outcomes. Native American girls (N = 181) in five middle schools and three high schools in a nearby city where there was no sexual assault prevention occurring completed surveys assessing sexual violence, physical dating violence, and sexual harassment victimization approximately six months apart, thus serving as a comparison to girls in the treatment condition on primary and secondary outcomes. Girls exposed to the IMpower program reported significant increases over time in efficacy to resist a sexual assault and knowledge of effective resistance strategies. Furthermore, propensity score analyses suggested that girls who received the IMpower program reported significantly fewer types of sexual assault and sexual harassment at follow-up compared to girls in the control condition. However, no effect was found for physical dating violence. These data suggest that empowerment self-defense is a promising approach in preventing sexual assault and sexual harassment among American Indian girls.