Feasibility, acceptability and effectiveness of a culturally informed intervention to decrease stress and promote well-being in reservation-based Native American Head Start teachers.
Feasibility, acceptability and effectiveness of a culturally informed intervention to decrease stress and promote well-being in reservation-based Native American Head Start teachers.
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DOI：
10.1186/s12889-023-16913-z
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发表时间：
2023-10-25
影响因子：
4.5
通讯作者：
中科院分区：
文献类型：
--
作者：
居住在保留地的美洲原住民虽然受益于与家庭、土地和文化的强大文化联系，但他们遭受心理痛苦的比率是一般人口的2.5倍。保留地社区的心理健康治疗利用率很低，缺乏文化上适当的护理。有证据表明，对于心理健康治疗，美洲原住民更喜欢文化上知情的护理，尊重土著人对健康和福祉的看法。为了减少压力，促进福祉部落先声夺人的教师，我们适应和实施了以文化为重点的干预，以社区为基础的参与性研究框架内使用混合方法。适应5节课的课程的可行性和可接受性进行了测试，在单臂干预研究的样本18名教师的佩克堡保留。参与者在基线和完成干预后完成调查。在会议观察和两个干预后焦点小组（n = 8，n = 10）进行了详细说明和解释的定量结果引起参与者的经验干预的有效性和可行性，可接受的和适当的。使用干预措施的可接受性、干预措施的适当性和干预措施的可行性对实施结果进行定量评估。从数量上看，总体出勤率为93%，没有辍学者。前测/后测调查进行了分析，使用t检验和对冲g来衡量效果大小。与我们的假设相反，自我感知的压力表现出一个小的正效应大小，表明参与者在干预后压力更大。然而，抑郁症减少，部落身份和韧性显示出积极的影响大小。内容分析的定性数据收集的会话观察和干预后的焦点小组揭示了终身创伤是如何影响参与者，提供了一些解释压力的增加。教师报告说，这些课程有助于他们的心理健康和福祉，支持未来干预措施的可行性。可接受性得分最高，平均值（SD）为4.25（.84）/5，适当性为4.18（.86），可行性为4.06（.96），支持干预是可接受、适当和可行的。利用文化为基础的干预缓冲压力和支持基于保留地的教师的福祉显示出希望，帮助他们认识到自己的文化优势，压力，并需要持续的支持。实施结果表明，扩大干预规模是可行的。
While benefiting from strong cultural ties to family, land and culture Native Americans residing on reservations experience psychological distress at rates 2.5 times that of the general population. Treatment utilization for psychological health in reservation-based communities is low with access to culturally appropriate care lacking. Evidence suggests that for mental health treatment, Native Americans prefer culturally informed care that respects Native perspectives on health and well-being. To decrease stress and promote well-being in tribal Head Start teachers we adapted and implemented a culturally focused intervention within a community-based participatory research framework using mixed methods. Feasibility and acceptability of the adapted 5-session curriculum was tested in a single arm intervention study with a sample of 18 teachers on the Fort Peck Reservation. Participants completed surveys at baseline and upon completion of the intervention. Within session observations and two post-intervention focus groups (n = 8, n = 10) were conducted to elaborate and explain the quantitative results eliciting participant experience of intervention effectiveness and feasibility, acceptably and appropriateness. Implementation outcomes were assessed quantitatively using the Acceptability of Intervention, Intervention Appropriateness, and Feasibility of Intervention measures. Quantitively, attendance rate overall was 93% with no dropouts. Pretest/posttest surveys were analyzed using t-tests and Hedges g to measure effect size. Contrary to our hypothesis, self-perceived stress showed a small positive effect size, indicating that participants were more stressed post intervention. However, depression decreased, with tribal identity and resilience showing positive effect sizes. Content analysis for the qualitative data collected within session observations and post intervention focus groups revealed how lifetime traumas were affecting participants, providing some explanation for the increase in stress. Teachers reported that the sessions helped their psychological health and well-being, supporting feasibility of future interventions. Acceptability scored highest with a mean (SD) of 4.25 (.84) out of 5, appropriateness 4.18 (.86) and feasibility 4.06 (.96) supporting intervention to be acceptable, appropriate, and feasible. Utilizing a culturally based intervention to buffer stress and support the well-being of reservation-based teachers showed promise in helping them recognize their cultural strengths, stress, and need for ongoing support. Implementation outcomes show that intervention scale-out is feasible.
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影响因子：
3.1
作者：
Biddle, Nicholas
通讯作者：
Biddle, Nicholas
影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
7.4
作者：
Connor, KM;Davidson, JRT
通讯作者：
Davidson, JRT
影响因子：
2
作者：
Balazs, Carolina L.;Morello-Frosch, Rachel
通讯作者：
Morello-Frosch, Rachel
DOI：
10.1353/cpr.2017.0035
发表时间：
2017-09-01
影响因子：
1.1
作者：
Brockie, Teresa N.;Dana-Sacco, Gail;Wetsit, Lawrence
通讯作者：
Wetsit, Lawrence