The development of the Promoting First Relationships home visiting program and caregivers' comments about their experiences across four RCT studies.

Promoting First Relationships (PFR) is an evidence-based home-visiting program for caregivers and their children from birth to age 5 years. It focuses on caregiver-child interaction, attachment, and relationship quality using video feedback of unedited recordings to elicit reflection and provide positive feedback linked to knowledge development. This paper provides a brief history of PFR and reports on a qualitative study of 222 caregivers' comments about their PFR experiences following participation in one of four randomized controlled trials conducted over the past decade in the United States (two studies within child welfare setting, one study with Native American families, and one study with Spanish and English-speaking mothers), using a thematic analysis approach to code excerpts from written satisfaction surveys and oral satisfaction interviews.

COVID-19 Disease and Chronic Health Outcomes Associated with Nicotine Use in a Great Plains Tribal Community: A Community-Based Study.

Background: The Cheyenne River Sioux Tribe (CRST) is affected by high nicotine use and disease burden. Understanding nicotine exposure is important to recognize what groups may be at higher risk for negative health outcomes, including COVID-19.

Objective: To compare self-reported health outcomes and nicotine use between exclusive electronic cigarette (e-cig) users, users of combustible cigarettes, dual e-cig/cigarette users, and nonusers among adult residents on the CRST.

Genetic variant rs1205 is associated with COVID-19 outcomes: The Strong Heart Study and Strong Heart Family Study.

Background: Although COVID-19 infection has been associated with a number of clinical and environmental risk factors, host genetic variation has also been associated with the incidence and morbidity of infection. The CRP gene codes for a critical component of the innate immune system and CRP variants have been reported associated with infectious disease and vaccination outcomes. We investigated possible associations between COVID-19 outcome and a limited number of candidate gene variants including rs1205.

Return of Participants' Incidental Genetic Research Findings: Experience from a Case-Control Study of Asthma in an American Indian Community.

The proper communication of clinically actionable findings to participants of genetic research entails important ethical considerations, but has been challenging for a variety of reasons. We document an instance of the return of individual genetic results in the context of a very rural American Indian community, in hopes of providing insight to other investigators about potentially superior or inferior courses of action. This was a case/control study of asthma among 324 pediatric participants.

Return of Participants' Incidental Genetic Research Findings: Experience from a Case-Control Study of Asthma in an American Indian Community.

Purpose: The proper communication of clinically actionable findings to participants of genetic research entails important ethical considerations, but has been challenging for a variety of reasons. We document an instance of return of individual genetic results in the context of a very rural American Indian community, in hopes of providing insight to other investigators about potentially superior or inferior courses of action.

Methods: The original study was a case/control study of asthma among 324 pediatric participants.

Efficacy and feasibility of the BREATHE asthma intervention with American Indian children: a randomized controlled trial.

American Indian (AI) children experience significant disparities in asthma prevalence, severity, and burden of disease, yet few asthma education interventions are tested in this population. This study aimed to evaluate the efficacy and feasibility of the BREATHE intervention with parents and AI children, during a 3-year follow-up period (n = 108), using a randomized controlled design. Children with asthma identified by electronic medical records (EMR) were screened and matched with 2 controls.

Implementation fidelity of the Promoting First Relationships intervention program in a Native community.

Promoting First Relationship (PFR) is an evidence-based intervention designed to promote positive, supportive relationships between primary caregivers and their young children. Implementing and testing the efficacy of PFR in a remote Native community is especially challenging and requires methods and tools for ensuring implementation fidelity. Tribal members of a Native community were successfully trained and certified to deliver PFR by university-based personnel.

Experiences of Native Participants in the Promoting First Relationships® Intervention: Focus Group Findings.

Objectives: We tested Promoting First Relationships® (PFR), an evidence-based preventive intervention program for caregivers promoting attachment and social and emotional development of infants and toddlers, in a randomized controlled trial in a Native community. Quantitative results yielded evidence of efficacy; but in this report, our objective was to assess the participants' real-life experiences, challenges, and suggested enhancements to further adapt the program.

Methods: At the end of the study we conducted three focus groups (N = 17)-two groups for participants who completed the 10-week intervention and one group for those who did not.

Promoting First Relationships for Primary Caregivers and Toddlers in a Native Community: a Randomized Controlled Trial.

This study tested the effectiveness of Promoting First Relationships (PFR), a preventive intervention program aimed at fostering positive caregiver-child relationships in Native families living on a rural reservation. Participants were 162 primary caregivers (96% Native; 93% female) and their Native toddlers (10-31 months old; 50% female). Families were randomized to a PFR group (n = 81) or Resource and Referral (RR) control group (n = 81), after baseline data collection (Time 1) to assess the quality of caregiver-child interaction, caregiver knowledge about children's social-emotional needs, caregiver depressive symptoms, and child externalizing behavior.

Developing the Tribal Resource Guide and the Poverty and Culture Training: The We RISE (Raising Income, Supporting Education) Study.

The We RISE Study aimed to support young American Indian mothers on a tribal reservation by addressing social determinants of health at an individual and community-wide level. To address community-based barriers, the study developed the Tribal Resource Guide, a comprehensive list of available resources that was created through partnerships with community programs and staff. In addition to the guide, the study also developed the Poverty and Culture Training in order to train program staff at numerous community programs to better understand and serve lower socioeconomic and/or Native clients.

Using Goal Setting and Attainment to Impact Indicators of Health Behavior Change among Young American Indian Women: The We RISE (Raising Income, Supporting Education) Study.

The purpose of the present study was to assess the association between setting and attaining goals and indicators of health behavior change (psychological general well-being index, self-efficacy, and health locus of control) among young American Indian mothers. A total of 60 women were randomized to either intervention or control. At the end of the 6-month intervention, goal attainment was not significantly associated with the three outcomes of interest.

Active smoking, secondhand smoke exposure and serum cotinine levels among Cheyenne River Sioux communities in context of a Tribal Public Health Policy.

Introduction: American Indians and Alaska Natives face disproportionately high rates of smoking and secondhand smoke (SHS) exposure. The Cheyenne River Sioux Tribe (CRST) is among the few Tribal Nations controlling commercial tobacco exposures in public and work places. We had an opportunity to explore effects of the new commercial tobacco-free policy (implemented in 2015) in an environmental health study (2014-2016) that collected information about commercial tobacco use and SHS prevalence and examined predictor variables of serum cotinine concentrations.

Dietary determinants of inorganic arsenic exposure in the Strong Heart Family Study.

Background: Chronic exposure to inorganic arsenic (iAs) in the US occurs mainly through drinking water and diet. Although American Indian (AI) populations have elevated urinary arsenic concentrations compared to the general US population, dietary sources of arsenic exposure in AI populations are not well characterized.

Methods: We evaluated food frequency questionnaires to determine the major dietary sources of urinary arsenic concentrations (measured as the sum of arsenite, arsenate, monomethylarsonate, and dimethylarsinate, ΣAs) for 1727 AI participants in the Strong Heart Family Study (SHFS).

Socioeconomic and Environmental Risk Factors for Pediatric Asthma in an American Indian Community.

Background: American Indian (AI)/Alaska Native children have increased asthma prevalence, morbidity, and mortality compared to non-Hispanic white children. Our study sought to examine environmental and socioeconomic factors of asthma among children in an AI community.

Methods: This case-control study included children with physician-diagnosed asthma and age-matched controls, ages 6 through 17 years, in an AI community.

Genetic variants and risk of asthma in an American Indian population.

Background: Asthma is recognized as a complex, multifactorial disease with a genetic component that is well recognized. Certain genetic variants are associated with asthma in a number of populations.

Objective: To determine whether the same variants increase the risk of asthma among American Indian children.

Humoral immune factors and asthma among American Indian children: a case-control study.

Background: Asthma is recognized as intimately related to immunologic factors and inflammation, although there are likely multiple phenotypes and pathophysiologic pathways. Biomarkers of inflammation may shed light on causal factors and have potential clinical utility. Individual and population genetic factors are correlated with risk for asthma and improved understanding of these contributions could improve treatment and prevention of this serious condition.

Asthma triggers on the Cheyenne River Indian Reservation in western South Dakota: the Breathing Relief Education and Tribal Health Empowerment (BREATHE) Study.

Background: The purpose of this article is to better understand asthma triggers and possible causes of exacerbations among BREATHE participants on the Cheyenne River Indian Reservation in western South Dakota.

Methods: To qualify for enrollment, participants had to have physician-diagnosed asthma, be uncontrolled and have persistent symptoms. Participants were asked to identify their top two asthma triggers throughout their one-year enrollment during initial visits and subsequent phone follow-ups.