Evaluating the Implementation and Dissemination of an Adolescent Sexual Health Program in American Indian and Alaska Native Communities

Background: American Indian/Alaska Native (AI/AN) youth health behaviors are influenced by a unique context of sociocultural and environmental factors. Mainstream messages regarding sexual health are frequently inappropriate and ineffective. Dissemination and evaluation of culturally appropriate, evidence-based programs is necessary to fill this gap. The objective of this study was to evaluate the implementation and dissemination of Native STAND, a curriculum designed to enhance and promote healthy decision-making regarding relationships, STIs, and teen pregnancy among AI/AN youth. Methods: 48 tribal health educators from rural and urban communities were trained to deliver the Native STAND curriculum. To date, 38 sites have implemented the curriculum, and 886 AI/AN youth have completed pre- and post- surveys on knowledge, attitudes, and behavior. Evaluation follows the RE-AIM framework and includes qualitative and quantitative measures of Reach, Effectiveness, Adoption, Implementation, and Maintenance at the levels of tribal organization, educator, and youth participant. Results: Data analysis is in progress. Preliminary analyses indicate positive shifts in health behavior. The percentage of 366 boys reporting they were “definitely sure” that could use a condom correctly increased from 46 to 63%, and 424 girls from 36 to 56%. Similarly, the percentage of 356 boys indicating they were “definitely sure” they could get a condom increased from 49 to 62%, and 428 girls increased from 39 to 51%. Implications: Project outcomes will expand available evidence toward the development of best practices for culturally appropriate adolescent sexual health education programming in AI/AN rural and urban communities