A Systematic Review of Trauma-Informed Sexual Health Education Interventions for Adolescents and Young Adults Within the United States and Canada

International Journal of Sexual Health · 2025-02-12 · 2 citations

Objective: To systematically identify and critically examine trauma-informed sexual health education interventions developed for adolescents and young adults and describe how they integrate key principles of a trauma-informed approach. Methods: Using the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) guidelines, Substance Abuse and Mental Health Services Administration (SAMHSA) principles, and Khan et al.'s review methodology, we reviewed sexual health intervention studies described as trauma-informed published between 2014 and 2023 within the United States and Canada. Results: The review found three interventions integrated five to six aspects of a trauma-informed approach relative to Kahn's definition and SAMHSA's principles. Conclusions: Based on the limited number of trauma-informed interventions being identified, this highlights a continuation of the gap in trauma-informed sexual health interventions.

A Systematic Review of Family Violence Prevention Among Indigenous Populations: A Call to Center Prevention Work in Strengths, Culture, and Dignity

Journal of Family Violence · 2025-03-12

Developing self-efficacy and ‘communities of practice’ between community and institutional partners to prevent suicide and increase mental health in under-resourced communities: expanding the research constructs for upstream prevention

BMC Public Health · 2025-04-08 · 3 citations

BACKGROUND: Suicide is a serious and growing health inequity for Alaska Native (AN) youth (ages 15-24), who experience suicide rates significantly higher than the general U.S. youth population. In under-served, remote AN communities, building on existing local and cultural resources can increase uptake of prevention behaviors like lethal means reduction, interpersonal support, and postvention by family members, workers and community members, which can be important for preventing suicide in places where mental health services are sparce. This study expands the variables we hypothesize as important for reducing suicide risk and supporting mental wellness. These variables are: (1) perceived suicide prevention self-efficacy, (2) perceived wellness self-efficacy, and (3) developing a 'community of practice' (CoP) for prevention/wellness work. METHOD: With a convenience sample (N = 398) of participants (ages 15+) in five remote AN communities, this study characterizes respondents' social roles: institutional role if they have a job that includes suicide prevention (e.g. teachers, community health workers) and community role if their primary role is based on family or community positioning (e.g. Elder, parent). The cross-sectional analysis then explores the relationship between respondents' wellness and prevention self-efficacy and CoP as predictors of their self-reported suicide prevention and wellness promotion behaviors: (1) working together with others (e.g. community initiatives), (2) offering interpersonal support to someone (3), reducing access to lethal means, and (4) reducing suicide risk for others after a suicide death in the community. RESULTS: Community and institutional roles are vital, and analyses detected distinct patterns linking our dependent variables to different preventative behaviors. Findings associated wellness self-efficacy and CoP (but not prevention self-efficacy) with "working together" behaviors, wellness and prevention self-efficacy (but not CoP) with interpersonal supportive behaviors; both prevention self-efficacy and CoP with higher postvention behaviors. Only prevention self-efficacy was associated with lethal means reduction. CONCLUSIONS: The study widens the scope of suicide prevention. Promising approaches to suicide prevention in rural low-resourced communities include: (1) engaging people in community and institutional roles (2), developing communities of practice for suicide prevention among different sectors of a community, and (3) broadening the scope of suicide prevention to include wellness promotion as well as suicide prevention.

Resilient Responses to Victimization and Other Trauma: Positive Emotion Regulation and Other Understudied Psychosocial Strengths

Journal of Interpersonal Violence · 2024-11-30 · 8 citations

Although many psychosocial strengths have been explored, there remains a need to identify under-appreciated strengths that help people overcome trauma. The objective of this study was to explore the resilience potential of 16 psychosocial strengths—including 4 understudied strengths (positive emotion regulation, self-reliance, relational motivation, and group connectedness)—for helping people overcome trauma. The understudied strengths were identified in previous qualitative work as salient in the southeastern communities where the study took place. The sample was comprised of 357 adults recruited from community events in Tennessee. Their average age was 37.6 years ( SD 15.6), and the sample was 65.8% female. They completed a survey with measures of 16 psychosocial strengths, polyvictimization, and a range of outcomes. Blockwise logistic regressions were conducted using subjective well-being and trauma symptoms as the outcome. Results indicated that positive emotion regulation was the best predictor of positive functioning after experiencing trauma. Polystrengths (an indicator of the breadth of a person’s resilience portfolios), a sense of purpose, and social support received were also associated with better functioning after controlling for polyvictimization, other adversities, and demographics. In multivariate analyses, religious meaning-making and relational motivation were unexpectedly associated with worse outcomes. Most studies of emotion regulation only explore the regulation of negative emotions, such as distress and anger, but the capacity to regulate positive emotions shows promise for helping people overcome trauma. The support for polystrengths, despite mixed findings for some strengths, points to the urgent need to identify the most helpful elements of resilience portfolios.

Correction To: The Indigenous Connectedness Framework for Understanding the Causes, Consequences, and Solutions to Substance Misuse in Indigenous Children’s Development

Adversity and Resilience Science · 2024-02-08

Social networks of American Indian youth on a Northern Plains reservation

Connections · 2024-01-01 · 1 citations

Social relations and multigenerational networks remain a salient fixture of American Indian (AI) culture and survivance. Network data can describe the dynamic nature of social networks and the powerful role these relationships play in the development of behaviors in adolescence. Research in other populations has demonstrated how networks impact risk and resilience, but data on these factors are lacking among AI adolescents. There are reasons to expect that network structures may differ and that prevailing social network theories may not apply among this population. This paper describes ego and grade level networks of 9th and 10th grade AI youth (N = 263) in three diverse schools on a Northern Plains reservation. Aligned with prior research, we find that gender homophily plays a role in friendship formation. Unlike in other settings, race/ethnicity was not a significant predictor of friendship ties; this finding is not surprising given that 94% of the sample identified as being from this Northern Plains tribe. The descriptive findings also suggest that AI youth have a significant portion of family ties, even among their school-based networks. This may be a distinct feature of AI networks. Variation in networks across schools suggests unique community contexts that may make a universal approach to prevention development and implementation less effective. Within this tribal community, we find significant differences in the types, sizes, and potential mechanisms of tie formation. This underscores the importance of identifying network variations to implement targeted preventive interventions for feasibility, efficacy, and sustainability.

Process improvement to increase rates of sperm-banking in AYA patients newly diagnosed with cancer: an institutional experience

Frontiers in Adolescent Medicine · 2024-03-18 · 2 citations

Background Despite ASCO and COG recommendations, increasing the rate of sperm-banking for newly diagnosed AYA males with cancer remains difficult. Multiple barriers to fertility preservation at pediatric institutions have been well described. Numerous logistical barriers can impede successful sperm cryopreservation. We analyzed our institution's experience in optimizing workflows to improve sperm-banking rates. Our processes improvement included: (1) striving for a fertility consult for each newly diagnosed male, (2) utilization of a member of the oncology provider team serving as a fertility navigator (FN) providing fertility consultation and counseling services. Methods Sperm banking rates at St. Louis Children's Hospital were reviewed and compared for three discrete calendar years spanning the implementation of these enhancements (2017, 2019, 2022). We plotted process changes over time to assess their impact on the rate of successful sperm-banking in eligible AYA males newly diagnosed with cancer. Results The rate of consults for sperm banking prior to therapy increased from 18% in 2017 to 91% in 2022 ( p = .0003). Rates of sperm banking in eligible males increased from 18% to 82% ( p = .0015) between 2017 and 2022. Conclusion Embedding a FN who is also a member of the primary oncology team increases not only the fertility consult rate but also the rate of successful sperm-banking in AYA males who are newly diagnosed with cancer at pediatric institutions.

‘Trauma sits in your body and makes you shut down:’ sexual and reproductive health professionals’ views of the impact of trauma on the sexual health of Native American older adolescent and young adult women

Culture Health & Sexuality · 2024-07-12 · 1 citations

A history of colonisation and corresponding traumas has resulted in disparate rates of violence and sexual health inequities among many Native American populations. As a result, Native American adolescents and young adults specifically, experience higher rates of STIs, HIV and unintended pregnancy relative to their non-Hispanic White counterparts. To address these inequities, sexual health education programmes should reflect Native American cultural values and traditional teachings to align with community assets and protective factors. The objective of this study was to describe sexual and reproductive health professionals' perspectives on how trauma collectively affects the sexual health of older adolescents and young adult Native American women between the ages of 15-25 years. We purposively sampled sexual and reproductive health professionals who worked with members of this priority population. Individual in-depth interviews were conducted, recorded, and transcribed. Transcripts were analysed using thematic analysis. The themes identified in the interviews include the impact of trauma and colonisation on sexual health, strategies for combatting trauma, promoting sexual health, and supporting the development of culturally congruent sexual health education curricula. Findings point to the need for culturally relevant, trauma-informed sexual health education interventions to help promote sexual and reproductive health equity for Native American adolescent and young adult women.

Considering the importance of ‘Communities of Practice’ and Health Promotion Constructs for Upstream Suicide Prevention

Research Square · 2024-03-12

Grounding evidence-based prevention within cultural context: promising effects of substance use prevention adapted for American Indian families

Substance Use & Misuse · 2023-04-26 · 8 citations

Effective substance use prevention strategies are needed for American Indian (AI) youth, who face disproportionate risk for early substance use and consequently bear a disproportionate burden of health and developmental disparities related to early use. With few exceptions, significant advances in prevention science have largely excluded this population, leaving gaps in the evidence of effective practice. This paper builds on emerging efforts to address this gap, reporting first outcome findings from an evidence-based early substance use prevention program culturally adapted for young adolescents on a Northern Plains reservation. Using a community-based participatory approach, the Thiwáhe Gluwáš’akapi Program (TG, sacred home in which family is made strong) was developed by embedding cultural kinship teachings within the Strengthening Families Program for Parents and Youth 10–14 and aligning other elements of program content with local culture and context. Results of pre and post comparisons of proximal program outcomes showed that youth reported significant improvements in parental communication about substance use, substance use resistance skills, stress management, family cohesion, and overall well-being. Adults reported improvements in a wide array of parenting behaviors and indicators of family dynamics. These findings provide an initial glimpse into the potential effects of the TG program and suggest that it holds promise for helping AI families address risks for youth substance use through positive impacts on modifiable risk and protective factors documented to influence early substance use.