Violence Prevention and Sexual Health Promotion Among American Indians and Alaska Natives

Abstract

American Indian and Alaska Native (AI/AN) persons experience high levels of intimate partner violence (IPV) and adverse sexual health outcomes. Exacerbating victimization, AI/AN victims face unique barriers to post-victimization help-seeking (e.g., services, disclosure). Further, IPV prevention is hindered by gaps in criminal jurisdiction that leave Indian tribes largely unable to prosecute non-AI/AN perpetrators, which may lead to differences in perpetration between AI/AN and non-AI/AN offenders. Finally, narrative communication approaches for health promotion for AI/AN youth and young adults specifically is increasingly common, but little studied. To explore differences between AI/AN and non-AI/AN IPV victims in help-seeking behavior, Chapter 1 uses respondent-level data from the 2010 National Intimate Partner and Sexual Violence Survey (NISVS) to conduct weighted logistic regression models for 13 different types of service needs and disclosure. Compared to non-AI/AN victims, AI/AN victims were more likely to report ever needing medical services and less likely to report ever needing legal services. Racial differences in post-victimization need for services provides an area for future research to better understand the needs of AI/AN victims of IPV. To investigate differences between AI/AN and non-AI/AN perpetrators, Chapter 2 uses perpetrator-level data from the 2010 NISVS to calculate crude odds ratios examining various aspects of IPV perpetration against AI/AN victims. Differential perpetration was most pronounced among female victims, with AI/AN perpetrators more likely to have perpetrated physical violence, but less likely to have committed sexual violence or stalking compared to non-AI/AN perpetrators. This differential interracial and intra-racial IPV perpetration suggests that the enhanced ability of AI/AN tribes to prosecute non-AI/AN offenders is warranted. Finally, Chapter 3 evaluates elements of a narrative sexual health intervention. Data from the Native VOICES intervention was used to examine relationships between the intervention, communication elements, and intervention outcomes. Overall, mixed evidence was found for the impact of either a narrative communication intervention or post-intervention facilitated discussion on communication elements and intervention outcomes. The intervention evaluation highlights the need for increased research to enhance the design and implementation of multimedia narrative communications to improve the health and wellbeing of AI/AN youth and young adults.