Pilot Test of a Cultural Intervention to Enhance Alaska Native Students' Behavioral Health

This project aims to enhance AN university students' behavioral health by supporting their cultural identity development. While the connection between cultural identity and behavioral health is becoming clearer, comparably less research has explored methods of enhancing identity development. Consequently, the investigators will pilot a cultural identity development program for AN students at the University of Alaska Anchorage (UAA). This intervention is based on extant scientific literature, local findings from focus group with AN students, and traditional wisdom from AN Elders. The eight-week Elder-facilitated program incorporates storytelling, experiential learning, connection, exploration, and sharing of identity, cultural strengths, life paths, and rootedness in who they are in order to remain grounded when they face changes and challenges. Approximately 40 to 50 AN university students will be recruited for the intervention. Participants will be randomized, with half the participants receiving the intervention in the Fall 2020 semester and half the students receiving the intervention in the Spring 2021 semester. We hypothesize that engaging in this intervention will strengthen AN students' cultural identities, strengths, and sense of community; improve their behavioral health, as evidenced in higher self-reported wellbeing, and lower substance use, depression, anxiety, and suicidal ideation symptoms; and support their academic persistence and achievement. Outcomes will be tested via mixed design analyses of covariance. Moreover, program feasibility will be examined through a process evaluation, which will entail thematic analyses of six focus groups with program participants (n=40-50) and with the Elders who facilitated the program (n=5).

Study Overview

• Status: Completed
• Conditions: Depression; Anxiety; Suicidal Ideation; Substance Use
• Intervention / Treatment: Behavioral: Knowing Who You Are (Becoming): Cultural Identity Intervention

• Study Type: Interventional
• Enrollment (Actual): 44
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Alaska
    • Anchorage, Alaska, United States, 99508
      • University of Alaska Anchorage

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• self-identify as Alaska Native,
• are registered as an undergraduate student at UAA,
• are at least 18 years old,
• speak English

Exclusion Criteria:

-

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Sequential Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention in Fall 2020; Participants will receive the intervention in Fall 2020	Behavioral: Knowing Who You Are (Becoming): Cultural Identity Intervention; 8-week cultural identity development program led by Alaska Native Elders
Other: Intervention in Spring 2021; Control in Fall 2020	Behavioral: Knowing Who You Are (Becoming): Cultural Identity Intervention; 8-week cultural identity development program led by Alaska Native Elders

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Degree of Identification with Cultural Identity at Baseline	Multigroup Ethnic Identity Measure (Roberts et al., 1999), a 12-item self-report measure developed for diverse groups that has been validated with Native people (e.g., Moran et al., 1999) to measure cultural identity. Range = 6-30, higher scores indicate greater identification with cultural identity	Baseline, Pre-Intervention
Change in Baseline Degree of Identification with Cultural Identity Immediately Following Intervention	Multigroup Ethnic Identity Measure (Roberts et al., 1999), a 12-item self-report measure developed for diverse groups that has been validated with Native people (e.g., Moran et al., 1999) to measure cultural identity. Range = 6-30, higher scores indicate greater identification with cultural identity	Immediately After Intervention
Change in Post-Intervention Degree of Identification with Cultural Identity at 6-Month Follow-Up	Multigroup Ethnic Identity Measure (Roberts et al., 1999), a 12-item self-report measure developed for diverse groups that has been validated with Native people (e.g., Moran et al., 1999) to measure cultural identity. Range = 6-30, higher scores indicate greater identification with cultural identity	Follow-Up, Approximately 6 Months After Intervention
Degree of Identification with Cultural Strengths at Baseline	Native Cultural Health Assessment Tool (White Shield, 2013), a 10-item self-report measure of cultural strengths in given time period (past month for project) that was developed for Native people to measure cultural strengths. Range = 10-50, higher scores indicate greater identification with cultural strengths.	Baseline, Pre-Intervention
Change in Baseline Degree of Identification with Cultural Strengths Immediately Following Intervention	Native Cultural Health Assessment Tool (White Shield, 2013), a 10-item self-report measure of cultural strengths in given time period (past month for project) that was developed for Native people to measure cultural strengths. Range = 10-50, higher scores indicate greater identification with cultural strengths.	Immediately After Intervention
Change in Post-Intervention Degree of Identification with Cultural Strengths at 6-Month Follow-Up	Native Cultural Health Assessment Tool (White Shield, 2013), a 10-item self-report measure of cultural strengths in given time period (past month for project) that was developed for Native people to measure cultural strengths. Range = 10-50, higher scores indicate greater identification with cultural strengths.	Follow-Up, Approximately 6 Months After Intervention
Strength of Sense of Community with Alaska Native People at University at Baseline	Sense of Community Index, Second Edition (Chavis et al., 2008), a 24-item self-report measure of membership in, shared emotional connection with, fulfillment of needs from, and mutual influence on a given community (e.g., Alaska Native community at UAA) that has been used with diverse populations. Range = 0-72, higher scores indicate greater sense of community.	Baseline, Pre-Intervention
Change in Baseline Strength of Sense of Community with Alaska Native People at University Immediately Following Intervention	Sense of Community Index, Second Edition (Chavis et al., 2008), a 24-item self-report measure of membership in, shared emotional connection with, fulfillment of needs from, and mutual influence on a given community (e.g., Alaska Native community at UAA) that has been used with diverse populations. Range = 0-72, higher scores indicate greater sense of community.	Immediately After Intervention
Change in Post-Intervention Strength of Sense of Community with Alaska Native People at University at 6-Month Follow-Up	Sense of Community Index, Second Edition (Chavis et al., 2008), a 24-item self-report measure of membership in, shared emotional connection with, fulfillment of needs from, and mutual influence on a given community (e.g., Alaska Native community at UAA) that has been used with diverse populations. Range = 0-72, higher scores indicate greater sense of community.	Follow-Up, Approximately 6 Months After Intervention
Degree of Wellbeing at Baseline	Wellbeing scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate greater wellbeing.	Baseline, Pre-Intervention
Change in Baseline Degree of Wellbeing Immediately Following Intervention	Wellbeing scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate greater wellbeing.	Immediately After Intervention
Change in Post-Intervention Degree of Wellbeing at 6-Month Follow-Up	Wellbeing scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate greater wellbeing.	Follow-Up, Approximately 6 Months After Intervention
Degree of Anxiety Symptoms at Baseline	Anxiety scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate more anxiety.	Baseline, Pre-Intervention
Change in Baseline Degree of Anxiety Symptoms Immediately Following Intervention	Anxiety scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate more anxiety.	Immediately After Intervention
Change in Post-Intervention Degree of Anxiety Symptoms at 6-Month Follow-Up	Anxiety scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate more anxiety.	Follow-Up, Approximately 6 Months After Intervention
Degree of Depression Symptoms at Baseline	Depression scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate more depression.	Baseline, Pre-Intervention
Change in Baseline Degree of Depression Symptoms Immediately Following Intervention	Depression scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate more depression.	Immediately After Intervention
Change in Post-Intervention Degree of Depression Symptoms at 6-Month Follow-Up	Depression scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate more depression.	Follow-Up, Approximately 6 Months After Intervention
Degree of Suicidality Symptoms at Baseline	Suicidality scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate more suicidality.	Baseline, Pre-Intervention
Change in Baseline Degree of Suicidality Symptoms Immediately Following Intervention	Suicidality scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate more suicidality.	Immediately After Intervention
Change in Post-Intervention Degree of Suicidality Symptoms at 6-Month Follow-Up	Suicidality scale of the Mental Health Inventory (Veit & Ware, 1983). Converted scores range from 0-100, higher scores indicate more suicidality.	Follow-Up, Approximately 6 Months After Intervention
Degree of Substance Use at Baseline	Items from the Monitoring the Future Survey (U. Michigan), a 9-item self-report measure of tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants, inhalants, sedatives, hallucinogens, and opioid use in past 30 days. Higher scores indicate greater substance use.	Baseline, Pre-Intervention
Change in Baseline Degree of Substance Use Immediately Following Intervention	Items from the Monitoring the Future Survey (U. Michigan), a 9-item self-report measure of tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants, inhalants, sedatives, hallucinogens, and opioid use in past 30 days. Higher scores indicate greater substance use.	Immediately After Intervention
Change in Post-Intervention Degree of Substance Use at 6-Month Follow-Up	Items from the Monitoring the Future Survey (U. Michigan), a 9-item self-report measure of tobacco, alcohol, cannabis, cocaine, amphetamine-type stimulants, inhalants, sedatives, hallucinogens, and opioid use in past 30 days. Higher scores indicate greater substance use.	Follow-Up, Approximately 6 Months After Intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Academic Achievement at Baseline	Grade point average (GPA) for a given semester.	Baseline, Pre-Intervention
Change in Baseline Academic Achievement Immediately Following Intervention	Grade point average (GPA) for a given semester.	Immediately After Intervention
Change in Post-Intervention Academic Achievement at 1-Year Follow-Up	Grade point average (GPA) for a given semester.	Follow-Up, Approximately 12 Months After Intervention
Rate of Students Maintaining University Enrollment Semester of Intervention	Enrollment for a given semester.	Immediately After Intervention
Rate of Students Maintaining University Enrollment Semester after Intervention	Enrollment for a given semester.	Follow-Up, Approximately 6 Months After Intervention
Rate of Students Maintaining University Enrollment One Year Post-Intervention	Enrollment for a given semester.	Follow-Up, Approximately 12 Months After Intervention

Collaborators and Investigators

• Sponsor: University of Alaska Anchorage
• Collaborators: National Institute of General Medical Sciences (NIGMS)

Study record dates

Study Major Dates

• Study Start (Actual): August 30, 2020
• Primary Completion (Actual): May 5, 2021
• Study Completion (Actual): May 31, 2022

Study Registration Dates

• First Submitted: August 30, 2020
• First Submitted That Met QC Criteria: September 18, 2020
• First Posted (Actual): September 23, 2020

Study Record Updates

• Last Update Posted (Estimated): December 11, 2023
• Last Update Submitted That Met QC Criteria: December 5, 2023
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Keywords: Wellbeing; Alaska Native; Cultural Identity; Sense of Community
• Additional Relevant MeSH Terms: Behavioral Symptoms; Mental Disorders; Chemically-Induced Disorders; Self-Injurious Behavior; Suicide; Substance-Related Disorders; Suicidal Ideation
• Other Study ID Numbers: 1210302; U54GM115371 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No