Flexibility and resilience in equity-centered research: lessons learned conducting a randomized controlled trial of a family-based substance use prevention program for American Indian families.

Meaningful and effective community engagement lies at the core of equity-centered research, which is a powerful tool for addressing health disparities in American Indian (AI) communities. It is essential for centering Indigenous wisdom as a source of solutions and disrupting Western-centric perspectives and inequitable and exclusionary research practices. This paper reports on lessons learned implementing an effectiveness trial of the Thiwáhe Glúwaš'akapi program (TG) program (translated as "sacred home in which families are made strong")-a family-based substance use prevention program-in a post-pandemic era with an American Indian reservation community that has confronted extreme challenges.

Co-creating a conceptual model of Indigenous relational wellbeing in early childhood: Planting seeds of connectedness.

The purpose of this article is to share our story of conceptualizing Indigenous early relational wellbeing (ERW), specifically reflecting American Indian and Alaska Native worldviews. Our approach is grounded in Indigenous methodologies and guided by a Community of Learning comprised of Indigenous and allied Tribal early childhood community partners, researchers, practitioners, and federal funders. We describe the steps we took to conceptualize caregiver-child relationships from an Indigenous perspective, center Indigenous values of child development, apply an established Indigenous connectedness framework to early childhood, and co-create a conceptual model of Indigenous ERW to guide future practice and research.

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

: 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.

The Indigenous Connectedness Framework for Understanding the Causes, Consequences, and Solutions to Substance Misuse in Indigenous Children's Development.

Research in Indigenous communities continues to lead innovations in the adversity and resilience sciences. These innovations highlight the strengths of Indigenous communities and are an act of resistance against prevailing stereotypes that Indigenous communities are vulnerable and wholly restrained by health deficits. The aim of this Supplemental Issue on is to highlight the promising new approaches and perspectives implemented by a group of engaged researchers and their community partners, as they seek to move resilience science research forward.

Characterization of Colorado residents and radon reduction behaviors through latent class analysis and path models.

Radon is a naturally occurring radioactive gas that enters homes through cracks in the foundation where accumulated levels can cause lung cancer. Within the United States (U.S.

Community perspectives on developmental screening of American Indian and Alaska Native children.

Children are highly regarded and treasured as the future of American Indian and Alaska Native (AIAN) communities. Developmental disorders, however, are more frequently undiagnosed and untreated in AIAN children compared to others in the United States. Developmental screening can help communities ensure that their children reach their full potential, but lack of culturally sensitive and valid screening measures complicates screening among AIAN children.

Exploring the feasibility of validating early developmental screening tools for American Indian and Alaska Native children.

Screening children from birth through age 5 is critical to early identification of challenges and referral to intervention to support optimal development. Screening of American Indian and Alaska Native (AIAN) children lags behind that of other children, partly due to the lack of screening tools validated for this population. This study tested the feasibility of an online data collection strategy for use in a future study of the validity of existing screening instruments for AIAN children.

Centering Indigenous Knowledges and Worldviews: Applying the Indigenist Ecological Systems Model to Youth Mental Health and Wellness Research and Programs.

Globally, Indigenous communities, leaders, mental health providers, and scholars have called for strengths-based approaches to mental health that align with Indigenous and holistic concepts of health and wellness. We applied the Indigenist Ecological Systems Model to strengths-based case examples of Indigenous youth mental health and wellness work occurring in CANZUS (Canada, Australia, New Zealand, and United States). The case examples include research, community-led programs, and national advocacy.

Implementation Factors and Teacher Experience of the Integrated Nutrition Education Program: A Mixed Methods Program Evaluation.

Background: School-based programs are widely implemented to address childhood obesity. Despite the promise of these programs, evidence on their effectiveness is mixed. Adopting a dissemination and implementation (D&I) science focus utilizing mixed methods can provide a broader understanding and more robust details about these programs.

Design and Effectiveness of the Youth Engaged Strategies for Changing Adolescent Norms! (YES-CAN!) Program for Reducing Skin Cancer Risk.

Adolescence is a critical period for reducing skin cancer risks, yet the development of effective interventions for middle and high school youth has lagged behind those for younger children. We developed and implemented the "Youth Engaged Strategies for Changing Adolescent Norms!" (YESCAN!) program, a school-based peer leader program that uses a youth-researcher partnership approach and a project-based curriculum to support high school students in developing and delivering short narrative videos and related material about skin cancer prevention to middle school students. Participating middle and high school students completed pre- and post-program surveys assessing skin cancer attitudes, perceived norms, and behavioral intentions.

Understanding the experience of the implementer: teachers' perspectives on implementing a classroom-based nutrition education program.

School-based programs are widely implemented to combat childhood obesity, but these programs have mixed results. Dissemination and implementation science approaches to evaluation using qualitative methods can provide more robust details about program functioning that may be able to help explain the variation in the impact of these programs. Fourteen in-depth interviews were conducted with classroom teachers implementing a school-based program, the Integrated Nutrition Education Program (INEP), to explore their experience.

Moving the prevention timeline: A scoping review of the literature on precursors to sexual risk in early adolescence among youth of color.

Introduction: Sexual health disparities are leading causes of morbidity among youth of color in the United States. We conducted a scoping review of the literature on precursors to sexual risk-taking among young adolescents of color (ages 10-14) to assess precedents of sexual experience and their utility as measurable proximal constructs and behaviors gauging sexual risk and sexual risk prevention efforts.

Methods: This study was conducted using the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines.

A Lifespan Model of Ethnic-Racial Identity.

The current paper presents a lifespan model of ethnic-racial identity (ERI) from infancy into adulthood. We conceptualize that ethnic-racial priming during infancy prompts nascent awareness of ethnicity/race that becomes differentiated across childhood and through adulthood. We propose that the components of ERI that have been tested to date fall within five dimensions across the lifespan: ethnic-racial awareness, affiliation, attitudes, behaviors, and knowledge.

PERSISTENT CONCERNS: QUESTIONS FOR RESEARCH ON ETHNIC-RACIAL IDENTITY DEVELOPMENT.

Research on ethnic-racial identity (ERI) and its development has increased exponentially over the past decade. In this paper we discuss five questions that the Lifespan ERI Study Group grappled with in our effort propose a lifespan model of ERI: (1) When does ERI development begin and end? (2) How do we account for age-dependent and contextually-initiated factors in ERI? (3) Should there be a reference point for healthy ERI, and if so, what is it? (4) How do the multiplicities of identity (intersectionality, multiracialism, whiteness) figure into our conceptualization of ERI? (5) How do we understand the role of ERI in pursuit of equity, diversity, and social justice? We note that these are persistent questions in ERI research, and thus our goal is to present our collective reckoning with these issues as well as our ponderings about why they persist. We conclude with recommendations forthe kinds of research questions, designs, and methods that developmental science, in particular, needs to pursue.

Integrating Community-Engagement and a Multiphase Optimization Strategy Framework: Adapting Substance Use Prevention for American Indian Families.

Initiation of substance use often occurs earlier among American Indian (AI) youth than among other youth in the USA, bringing increased risk for a variety of poor health and developmental outcomes. Effective prevention strategies are needed, but the evidence base remains thin for this population. Research makes clear that prevention strategies need to be culturally coherent; programs with an evidence base in one population cannot be assumed to be effective in another.

An Intervention Science to Advance Underrepresented Perspectives and Indigenous Self-Determination in Health.

This concluding article to the Supplemental Issue on Promoting Health Equity through Rigorous, Culturally Informed Intervention Science: Innovations with Indigenous Populations in the United States draws themes and conclusions from the innovative practices implemented by the National Institutes of Health Intervention Research to Improve Native American Health (IRINAH) consortium. The IRINAH work highlights promising practices for advancing the diverse and underrepresented perspectives essential to develop and test culturally appropriate, effective health interventions in American Indian, Alaska Native, and Native Hawaiian settings. Four emergent themes appear through the IRINAH work.

Promising Practices for Promoting Health Equity Through Rigorous Intervention Science with Indigenous Communities.

Research in indigenous communities is at the forefront of innovation currently influencing several new perspectives in engaged intervention science. This is innovation born of necessity, involving efforts to create health equity complicated by a history of distrust of research. Immense diversity across indigenous cultures, accompanied by variation in associated explanatory models, health beliefs, and health behaviors, along with divergent structural inequities add further complexity to this challenge.

Dissemination and uptake of HIV/STD preventive interventions in American Indian and Alaska Native communities: a case study.

HIV and sexually transmitted diseases (STDs) are serious health conditions among American Indian and Alaska Native (AIAN) populations, especially youth. However, few sexual risk reduction evidence-based interventions (EBIs) have been implemented by AIAN-serving organizations. This project sought to identify and assess the parameters facilitating the uptake and use of EBIs in order to strengthen opportunities for sustainability and improved sexual health among AIANs.

Pathways of Adaptation: Two Case Studies with One Evidence-Based Substance Use Prevention Program Tailored for Indigenous Youth.

Indigenous communities often face disproportionate challenges across a variety of health domains, and effective prevention strategies are sorely needed. Unfortunately, evidence is scant regarding what approaches are effective for these communities. A common approach is to take an evidence-based practice or program with documented effectiveness in other populations and implement it with Indigenous populations.

APPROACHES TO THE EVALUATION OF CULTURAL ADAPTATIONS OF HOME VISITING IN TRIBAL COMMUNITIES.

The research that underlies evidence-based practices is often based on relatively homogenous study samples, thus limiting our ability to understand how the study findings apply in new situations as well as our understanding of what might need to be adapted. In a preliminary effort to address those gaps, the requirements for the Tribal Maternal Infant and Early Childhood Home Visiting Program (MIECHV) included the expectation that grantees design and implement rigorous evaluations to address local priorities and to help build the knowledge base regarding the use of evidence-based home-visiting programs in tribal communities. A priority that emerged across many Tribal MIECHV grantees was to determine the added benefit of the cultural adaptations that they were making to their home-visiting programs.

METHODOLOGICAL CONSIDERATIONS FOR HOME-VISITING RESEARCH IN TRIBAL COMMUNITIES.

Drawing on previous studies and the collective experience of conducting rigorous evaluations as part of the Tribal Maternal, Infant, and Early Childhood Home Visiting grants, we outline methodological considerations that will inform future research in tribal communities, particularly in the area of home visiting. The methodological issues we discuss are study design choices, measurement and data collection, and including community members in all aspects of the research.