Addressing the Cultural Challenges of Firearm Restriction in Suicide Prevention: A Test of Public Health Messaging to Protect Those at Risk.

OBJECTIVES: Reducing access to firearms as a suicide prevention strategy is limited in the US today because of divergent cultural attitudes and political contentiousness surrounding gun restrictions. This research examined the effects of culturally-specific suicide prevention messages on the likelihood of restricting firearm access during periods of suicide risk. METHODS: Focus groups and key informant interviews were conducted with rural gun owners in order to develop a suicide prevention message that highlighted the importance of restricting access to firearms during periods of risk without threatening second amendment concerns. The effectiveness of this gun culture message, relative to standard suicide prevention messaging and a control condition, was then tested with a national sample of gun owners. RESULTS: Relative to all other conditions, respondents who received our culturally-specific message in conjunction with standard suicide prevention content reported the greatest likelihood of taking steps to restrict access to firearms. This tendency was enhanced for individuals who were more politically conservative, lived in more rural areas, and supported gun rights to a stronger degree. CONCLUSIONS: Findings underscore the importance of attending to cultural factors in public health messaging. Messaging that respects the values of gun owners could hold promise in promoting firearm restriction for suicide prevention.

A culture gap in the United States: Implications for policy on limiting access to firearms for suicidal persons.

Suicide is a critical public health problem worldwide. In the United States (US), firearm ownership is common, and firearms account for the majority of deaths by suicide. While suicide prevention strategies may include limiting access to firearms, the contentious nature of gun regulations in the US, particularly among members of rural communities, often gives rise to constitutional concerns and political polarization that could inhibit suicidal persons from seeking the help they need. We examine potential outcomes of public health strategies in the US that encourage limiting access to firearms for populations who both value firearm ownership and are vulnerable to suicide. Based on preliminary results from a firearm safety study, we argue that attempts to limit access to firearms among those at risk of suicide will only succeed when the most affected cultural groups are engaged in collaborative discussions.

Assessing health in an Alaska native cultural context: The Yup'ik Wellness Survey.

OBJECTIVES: The development and validation of a wellness measure among the Yup'ik of the Yukon-Kuskokwim Delta in western Alaska is presented, with the overarching goal of supporting locally relevant health practices in this Alaska Native population. METHOD: A survey containing the wellness measure and several additional psychosocial variables was completed by 493 Yup'ik individuals from 7 different highly rural communities in western Alaska. Participants ranged in age from 14 to 94 (M = 38.55, SD = 17.14), and slightly more than half were female (58.62%). RESULTS: Individuals who scored higher on the wellness measure reported greater happiness, greater overall health, greater communal mastery, a larger and more satisfying social support network, and coping styles that were more likely to be active, accepting, and growth-oriented, and less likely to involve drugs and alcohol. CONCLUSIONS: This project advances research on the health implications of enculturation by specifying particular patterns of culturally sanctioned beliefs and behaviors that appear most beneficial.

Enculturation, perceived stress, and physical activity: implications for metabolic risk among the Yup'ik--the Center for Alaska Native Health Research Study.

OBJECTIVES: American Indians and Alaska Natives (ANs) report among the lowest levels of physical activity in the USA, but there is very little systematic research examining the determinants of physical activity patterns in these populations. This study investigated the relationships between enculturation (or cultural traditionality), psychosocial stress, and physical activity in a community-based sample of Yup'ik women and men living in rural AN communities. Associations between these variables and several metabolic risk factors were also examined. DESIGN: A sample of 488 Yup'ik participants (284 women and 204 men) from six villages in the Yukon-Kuskokwim Delta region completed a wellness survey and an array of physiological assessments [e.g., body mass index (BMI), blood pressure]. A subset of 179 participants also completed a 3-day pedometer assessment of physical activity. RESULTS: Multivariate linear regression models indicated that participants who were more enculturated (i.e., living more of a traditional lifestyle) and who experienced lower levels of psychosocial stress were significantly more physically active. In turn, both lower levels of psychosocial stress and higher levels of physical activity were associated with lower BMI, lower percent body fat, and lower waist circumference. CONCLUSIONS: Findings underscore the importance of gaining a culturally specific understanding of physical activity patterns in indigenous groups in order to inform effective health promotion strategies.

Smoking, chewing, and cultural identity: prevalence and correlates of tobacco use among the Yup'ik-The Center for Alaska Native Health Research (CANHR) study.

Survey data were obtained from a large sample of Yup'ik participants residing in the Yukon-Kuskokwim Delta region of Alaska. Tobacco use, age, sex, and a variety of psychosocial variables were assessed. Over 75% of participants use tobacco; one half (57.4%) reported using smokeless tobacco (SLT) regularly; 28.2% reported smoking cigarettes regularly. Relative to women, men reported using SLT less, smoking cigarettes more, and using the combination of cigarettes and SLT more. Younger participants tended to smoke cigarettes more, and to use the combination of cigarettes and SLT more. SLT users displayed significantly greater enculturation by identifying more with a Yup'ik lifestyle and less with a White lifestyle, speaking their traditional language more frequently, and consuming more traditional food and medicine. In contrast, smokers tended to display significantly greater acculturation and reported using drugs and alcohol more to cope with stress. Discussion focuses on appreciating the influence of cultural factors on health behavior and on implications for intervention.

Stress, coping, and well-being among the Yup'ik of the Yukon-Kuskokwim Delta: the role of enculturation and acculturation.

OBJECTIVES: To report on the relationships between cultural identity and stress, coping, and psychological well-being in Yup'ik communities. STUDY DESIGN: A quantitative self-administered questionnaire. METHODS: A health and wellness survey was completed by a total of 488 Yup'ik participants (284 women and 204 men) from 6 rural villages in the Yukon-Kuskokwim Delta region. Respondents were fairly equally distributed across an age range of 14 to 94 (mean +/- SD = 38.50 +/- 17.18). RESULTS: Participants who reported living more of a Kass'aq way of life (greater acculturation) reported experiencing greater psychosocial stress, less happiness, and greater use of drugs and alcohol to cope with stress. Participants who reported identifying more with a traditional Yup'ik way of life reported greater happiness, more frequent use of religion and spirituality to cope with stress, and less frequent use of drugs and alcohol to cope with stress. CONCLUSIONS: In conjunction with previous research, the data strongly indicates that in general, Yup'ik people in the Y-K Delta tend to associate stress and negative health outcomes with the process of acculturation, and health and healing with the process of enculturation. Research that focuses on documenting the intrinsic strengths of indigenous worldviews may contribute to positive transformations in community health.

Conceptions of wellness among the Yup'ik of the Yukon-Kuskokwim Delta: the vitality of social and natural connection.

Focus group research was conducted to examine indigenous conceptions of wellness among the Yup'ik Eskimos of southwestern Alaska. The dialogue on wellness emphasized the importance of living a traditional lifestyle, seeking creative solutions to manage drastic cultural change, and fostering connection within the communities and the native landscape. These themes mesh well with existing characterizations of Alaska Native experiences and worldviews, and reflect substantial links between enculturation, acculturation and health. The data underscores the importance of comprehending local conceptions of wellness in order to effectively work toward promoting optimal health. This paper represents part of an ongoing dialogue in which researchers and native communities co-direct the investigation into healthy ways of being in the world.