Understanding Mental and Behavioral Health of American Indian Youth: An Application of the Social Convoy Model

Objective: The purpose of this dissertation was to examine three distinct, yet related studies. The primary focus of each chapter is the examination of mental and behavioral health among North American Indigenous (American Indian, Alaska Native, and Canadian First Nations) youth - motivated by relational perspectives. Method: Data for this dissertation came from baseline data of a larger randomized control trial of a culturally adapted evidence-based substance use prevention program among 375 youth and 304 caregivers across four reservations that share a similar language, history, and culture. Study 1 Results: The aim was to examine caregiver and youth agreement on internalizing and externalizing symptoms and identify unique predictors of agreement between youth and caregiver. This study shows that caregivers perceive significantly fewer internalizing symptoms compared to youth self-reports. Externalizing problems, were not significantly different between caregivers and youth. Diverging patterns are found that significantly reduce disagreement for internalizing compared to externalizing. Study 2 Results: The aim was to examine the role of sibling influence on problem behavior. Using a dyadic approach, bivariate analyses as well as actor-partner interdependence models (APIM) were conducted. Correlations suggest self-reported happiness with female caregiver is associated with externalizing behavior. Older siblings showed significant within group differences for externalizing problem behavior scores based on caregiver education level–caregivers with college degree or higher indicating the highest average externalizing scores relative to other education categories. No sibling/actor influences were noted in the API Models. Study 3 Results: The purpose of this study was to explore problem behavior among Indigenous youth using individual social convoy characteristics as predictors of externalizing behavior. Consistent with the extant literature, females, when compared to male counterparts, had significantly lower externalizing problem behavior. Self-reported mastery remains significant in multivariate regression analyses. Interaction between network size and being connected to a caregiver in the networks is also a significant predictor of externalizing behavior. Conclusion: These three studies individually and collectively demonstrate the benefits of taking a relational approach to understand problem behaviors among Indigenous youth. Further, this dissertation fosters support for prevention models that aim to reduce mental and behavioral health problems in relational contexts