ELTON: Good afternoon, everyone.
My name is Elton Oswood [phonetic].
I am a Senior Program Analyst
with the Office of Minority Health Resource Center.
We are very happy today to be able to
collaborate with the Northwest Area Indian Health Board
on a presentation today
with their colleagues and partners on the
Healthy Native Youth: A One-Stop Shop
for Educators Who Want to Expand Learning Opportunities
for the American Indian/Alaska Native Youth.
Next slide.
The presenters today include Tommy Ghost Dog Jr.,
who is the Project Assistant
with the Northwest Portland Area Indian Health Board,
Stephanie Craig Rushing,
who is the Project Director
of the Northwest Tribal Epidemiology Center
with the Northwest Portland Area Indian Health Board,
as well as with Jennifer Torres Jones,
who is a Research Coordinator II
at the University of Texas
Center for Health Promotion and Prevention Research.
We also have joining us today Nicole Tuitt,
who is a Senior Professional Research Assistant
with the Centers for American Indian and Alaska Native Health
at the Colorado School of Public Health.
We also have Amanda Gaston, who is also with
the Northwest Portland Area Indian Health Board,
and finally we'll end our presentation today
with David Stephens, who is with
the Northwest Portland Area Indian Health Board.
Next slide.
Our agenda today are going to be
with presentations on the youth health tech trend,
the web portal of the Healthy Native Youth,
and some of the programmings that are available
through the web portal, which include
Native It's Your Game, m Circle of Life,
concerning school media post-trainings,
and We R Native text messaging.
And for our participants who are online,
if you have any questions,
feel free to text those in the text box,
and we will be able to present those questions
at the end of the presentation for our presenters.
Again, if you have any questions during the presentation,
please type those in the text box,
and we will have the panelists address those questions
at the end of the presentation.
And without further ado, I'd like to have
Mr. Tommy Ghost Dog be able to present our first section.
TOMMY: Hello, everyone.
My name is Thomas Lee Ghost Dog Jr.
I'm an enrolled member of the Burns Paiute Tribe,
which is located in southeast Oregon.
I'm also Oglala Lakota on my dad's side.
And I am the Project Red Talon assistant here
at the Northwest Portland Area Indian Health Board.
I also specialize with our adolescent health program,
We R Native, which is an online media resource
for native youth by native youth,
and I specialize more so in leading our 150
We R Native youth ambassador program.
Thank you for being on this webinar.
To start off the webinar, we want to share with you
some youth trends and some numbers
that we received from a survey we conducted in 2016.
Next slide.
In 2016, we conducted what we called
the Youth Health Tech Survey,
and what it was was a survey around technology and health,
and we targeted three main events that youth are at.
Those three main events that youth were at --
the first one was the National Unity Conference,
which is a conference held every summer that has --
well, this last year had about almost 2,000
Native American youth in attendance,
so that was the first big event that we targeted
with disseminating this Health Tech Survey.
The next event was our own youth conference,
our THRIVE Conference that is held
in Portland, Oregon, at the end of June, and
there were about 75 attendees in that conference as well.
And then the third place that we disseminated
this Youth Tech Survey was
at the Tremala [phonetic] Indian Boarding School,
which is located in Salem, Oregon.
As you can see on this slide,
it has a good representation of the population
and the numbers of where those youth participants were from,
and in total we had a number of 679 respondents,
and as you can see, Arizona was our number one state,
followed by the state of Washington.
These next few slides will be some numbers
that we have from this Youth Tech Survey,
but also numbers that we feel are important to share
if you work with Native youth
or if they're your target audience
and ways to reach them where they're at.
Next slide.
With this slide, it kind of just breaks down the numbers
and the gender distribution
through the Health Tech Survey that we had,
and I really like to point out the age range
with 59% being 19- to 24-year-olds.
Our services do provide to the 13- to 24-year-old age range,
but in this particular case, we're pretty excited
that 59% or more so in the 19- to 24-year-old age range.
Also, 100% of the respondents were
American Indian or Alaska Native.
Next slide.
In here, we created a pictograph of what health topics
are important for Native youth to learn about.
As you can see, these were all the topics
that Native youth felt or they wanted to know more
and have resources pertaining to these different health topics,
and it's also interesting to point out that
after the survey was completed, we had input
from several youth at several other youth events
that sleep was another health topic
that the Native youth really wanted to learn about and
learn about the sleep patterns and getting enough sleep,
so definitely sleep was added to that list
of the health topics that are important to the youth.
Next slide.
As you can see, the question was,
what percent of Native youth say they do the following
on a daily basis?
And for a while it was a misconception
that Native American youth were not finding service
or getting online, but as you can see from our survey,
76% go online from a phone or a mobile device.
Native American kids will find service
or try to find Wi-Fi so they can log into their Facebook
or check their Instagram or post to Snapchat,
which you can see that Snapchat, Instagram and Facebook
are the top three platforms
that Native American youth are using.
And the other numbers kind of describe what they see
on their Facebook or what they see on their social media.
And I really want to point out the help and support.
So 24% experienced people supporting them
through tough times on social media.
So we really want to increase that number,
because as you will learn in this webinar,
Native American youth are going to social media
to express the way they feel, so -- yeah.
Next slide?
With this last slide that I will be presenting,
where do Native youth
say they get a lot of their health information from?
So as you can see, 36% of Native American youth
say they get their health information
from a social networking site.
So we really want to meet the Native youth
where they're at and where they're accessing information
and providing them medically accurate health information.
As you view this slide, you can see at the bottom
that only 19% of the Native youth
get their health information from a school or health class,
so we really want to be the leader
in providing that medically accurate health information
for youth and really meeting them where they're at
through their social media platforms.
Thank you for having the time to see
some of the youth trends that are going on today,
and with that being said
I will pass it to Dr. Stephanie Craig Rushing.
Next slide.
DR. RUSHING: Thanks, Tommy. This is Stephanie.
I work at the Northwest Portland Area Indian Health Board,
along with Tommy and David and Amanda,
and we have been working on a variety
of different adolescent health promotion projects,
a few of which we're going to share today,
and if you click over to the next slide,
you'll see one of the newer resources
that we have been working on.
As Tommy was saying in his last slide,
only 19% of youth say they get
medically accurate health information from school,
and we as health educators
of course felt a little concerned about that and
wanted to help support educators and health professionals
to deliver that culturally appropriate information
in school settings, and we're realizing
that it was kind of difficult to locate those.
The really exciting news is that
communities and tribes across the country
have been collaborating to adapt programs,
but they were very dispersed,
and so we recognize that, in order to be effective,
health curricula must be age-appropriate
and culturally relevant and reflect
the values and learning styles of the learners being taught,
and so we really wanted to design a website
that could help teachers and educators locate those curricula
and serve as a one-stop shop for folks
to support education among teens and young adults.
Next slide.
We won't feel sad if you click over to a new web browser
and open up the website and surf as we chat,
because it's really a, I think,
fun and kind of interactive space
that you'll have to spend some time searching around.
We're only going to share a few of the programs
that are available on the site,
but in total there are now eight culturally relevant
programs that have been added to the site.
Most of them focus around sexual health topics,
but there are other curricula being added to the site
that focus on other health promotion topics,
and really the goal is really to find
programs that support healthy decision-making
and empower teens to make healthy choices,
and so those are the programs
that we're looking to add to the website.
From this curricula tab, you can click
on the name of a program to learn more about it,
including the intended age group,
where it can be implemented,
and how much time is required to implement each program.
They range from one-hour lessons
all the way up to 29-lesson programs,
so you'll probably have to,
depending on the needs of your setting
and the constraints that you have,
choose a program that is appropriate to your setting.
Next slide.
These are some tools that will help you
in that searching process.
You can filter your search by the particular age group
that you're working with,
whether the program is LGBT and two-spirit inclusive,
what setting the program has been delivered in,
whether it is a school-based curriculum or after school
or can be flexibly implemented in a variety of settings.
And we know that some communities
are required to implement programs
that meet a certain level of evidence for certain funders,
and so if you need to select a program
that is either a best practice or promising practice
or a tribal best practice,
you can search by those criteria also
to find programs that meet those criteria.
Next slide.
And then this page allows folks
to compare one or more programs to each other,
kind of side-by-side, on some other criteria
like class size or cost or program duration,
so this will also help you compare programs
and select a program that best meets your community's needs.
Next slide.
Once you have selected a program,
for example if you select the Native Voices curriculum,
this particular intervention is a 23-minute video intervention
designed to encourage condom use and STD testing
among Native teens and young adults.
You'll start with a cover page
with information about the program,
and then you can see within each program
different folders related to that curriculum.
This example includes the training, lesson plans,
supporting materials -- there's information
about its cultural relevance, the adaptation process
or the process of creating the original program
to maintain cultural context.
There's also a section about the evaluation
and how it was evaluated,
and then references like community reports
and journal articles or any publications
related to that particular curriculum.
And from the Training tab,
you can get usually videos or webinars
that will prepare you as an educator
to implement the curriculum,
so that's a good place to start
to get a little overview of what it takes
to implement the program,
and then from the Lesson Plans page
you can download a ZIP file that contains
all of the program materials and all of the folders
so you don't have to download the lesson plans,
the Teacher's Guide, participant manuals --
all of those things can be downloaded in a single ZIP file
from that Lesson Plans page.
Next slide.
This site also has a list of
adolescent health resources and tools for educators,
some links to resources for youth,
some social marketing campaigns
that have been designed to promote adolescent health
for Native teens, links to those campaign materials.
So just a variety of different resources
for educators to promote adolescent health
in school or community settings.
Next slide.
We are really actively on the lookout
for new curricula to add to the site.
If you happen to have a health program
that you would like to share,
whether it's on nutrition or tobacco prevention
or drug and alcohol prevention,
we would love to partner with you
to add other curricula to the website.
There is a tab at the top of the website
that allows folks to submit new programs,
and we're looking for all sorts of topics
to eventually include on the website.
Next slide.
We'll give you a sense of kind of the eligibility criteria.
We want to promote positive youth development, programs
that have been purposefully designed for Native teens,
that embrace cultural teachings and learning styles
and that have been evaluated by your community or programs.
Please be on the lookout for programs and let us know
if you think anything might meet those criteria.
Next slide.
We also have a couple of activities going on
to encourage folks to use curricula on the website,
so this is perfect timing.
Happy Native Heritage Awareness Month. Next slide.
We have a back-to-school challenge going on,
and just select any of the programs that are
available on the website and implement it
with a group of students,
and you can click on a feedback form
which is available on almost every page of the website.
Next slide. We'll show you the first section
of that feedback form.
If you fill out that feedback form
between now and maybe the first week of December
we'll be sending out prizes to folks
who submit feedback about implementing a program
on the website. Next slide.
The first 10 entries will get $250 in school supplies,
and all participants will get We R Native
and Spawn Safely promotional materials,
and I know for a fact that there are remaining slots available,
so take a look, select a curriculum, implement it,
and even if you're in the process of implementing it,
you can fill out the feedback form
and be entered to win one of many great prizes.
Next slide.
I will kick it over to Jennifer Torres.
JENNIFER: Hi, everyone.
This is Jennifer Torres Jones.
It's great to be a part of this panel.
I'm going to be covering one of the curricula
on the Healthy Native Youth website,
and that's Native It's Your Game.
A little bit about the background of the team
who developed Native It's Your Game --
it was a collaborative partnership
between some tribal organizations
in Arizona and the Pacific Northwest, in Alaska
and then the University of Texas School of Public Health,
where I am. Next slide.
When you click on the Native It's Your Game tab
via the Healthy Native Youth website,
you will come to the little introduction page,
which Stephanie explained,
and you get some snippets and a summary
about what the program is and a few of the features.
It's free. Training is not required.
Anybody can kind of implement this.
And it is an HIV, STD and teen pregnancy prevention program
for middle school youth who are American Indian/Alaska Native.
So around the ages 12 to 14.
It can be implemented in the school, so in the classroom,
or also extracurricular programs,
so it could be an after-school program.
It could even be at home, if parents are interested
in taking their own kids through a program.
It's definitely capable of being implemented anywhere.
Next slide.
To get to it, once you have clicked on the tab
and you want to learn more,
if you go to that Lessons Plan tab on that intro page,
it will bring you to this page,
which is how you sign up for an account
and log in to access the lessons.
So again, all you need to do is sign up for an account.
You don't need anything extra. It takes less than five minutes.
This is where both facilitators and youth access the program.
If you are a facilitator or an adult
hoping to take some youth through this program,
you would sign up for an account,
and then it would actually enable you
to have kind of a virtual classroom
where students can be added to your classroom, and
you can track their progression throughout the program.
There are 13 lessons,
and they're about 30 to 50 minutes each.
So when you go into this, you will see
all of your students that you've added
or that have enrolled in your classroom,
and then you can follow along
how far they're progressing through the program.
You can also access their grades to quizzes
that they take at the end of the lesson.
Those are optional. But facilitators might choose
to offer their youth some of those quizzes.
And then they can just keep up with their group of kids.
As far as youth enrollment, there are two ways that youth
can enroll into the Native It's Your Game curriculum.
They can sign up themselves, just like they would
with any other account,
and then add themselves to an existing classroom,
so they would have to know their teacher's name
or the name of the group that you created.
Or, as a facilitator, you can set up
your own student profiles.
So when you start your group,
you can create profiles for your students
and give them usernames and passwords.
A little bit more time-consuming,
but worth it in the end if you want to have
everybody's username and passwords so they won't
lose them every day. Next slide.
This is just a snapshot.
Once you get in, you see a list of the lessons.
Again, I said there were 13 lessons,
and they take 30 to 35 minutes each.
It's a mixture. The curriculum ranges from topics
from healthy friendships, healthy relationships,
puberty and reproduction, HIV/STDs, pregnancy,
refusal, communication skills and contraception.
Covering all those topics, we use a mixture
of videos, different interactive activities like games,
quizzes, animated scenarios and also journal activities.
And so kids get to go through an experience.
It also is tailored to them.
The beginning of each lesson, they're asked
which gender do you identify with most,
and they're asked that before each lesson.
So it really does allow it to be LGBTQ-inclusive,
because not only can they choose gender
and they can choose a different one on different days,
but they also get to choose their partners for role-plays.
So when they're doing their practice skills,
when they're doing scenarios,
they can choose their own partners to practice with,
and it's not default by whatever gender that they choose.
Next slide.
This is an adaptive program.
Our team adapted the program,
and it went through a long process that,
if you'd like to know more about,
you can access on the Healthy Native Youth website,
in the cultural relevance section.
And we went through a lot of changes
as far as making it more culturally relevant
for American Indian/Alaska Native youth.
And a few of the things we did, I'll highlight here.
We definitely added in Native youth.
We redid all the videos of the peer videos
so that they could see kids who look more like themselves.
We added elders, and then a health educator
who reflect tribal and youth perspective
so that things could be set in a more cultural context.
Next slide.
Just another example of a cultural adaptation is
we redid a few activities,
and this is one of the ones that was redone
by our Alaska partners,
and this is an activity about elder wisdom.
It has the grandpa and the grandson,
and they're fishing, and they're having a talk
really about life but really about the grandson's decision
to take his relationship to the next level.
And so one of the things that we wanted to make sure to do
is frame pregnancy prevention in a good light
so that teen pregnancy isn't seen as something negative,
but that it's just seen as a life choice
as far as when you choose to engage in sexual activity
as a personal choice and a life choice.
And then in this particular story, the grandfather
goes through pros and cons of waiting
or choosing to have a family now.
Next slide.
Those are just a few highlights.
We really encourage you to go check it out.
I'm going to talk a little bit more about the actual studies.
When we adapted it, we tested Native It's Your Game,
and there were two study arms,
the intervention study arm that got Native It's Your Game,
and then the other group got a suite
of health-related online kind of programs
that weren't related to sexual health.
We had 25 sites.
They were randomized to one of the two study arms.
And again, they were in Alaska and then Pacific Northwest
and in Arizona.
We had about 574 middle school youth enrolled,
and we conducted pre-, immediate post- surveys
and 12-month-followup surveys.
Next slide.
We got some good results there.
The youth who took Native IYGs reported
that they had more reasons not to have sex,
increased STI knowledge, increased condom knowledge,
more confidence obtaining condoms
and more confidence about using condoms.
This is compared to the students who didn't receive
Native IYG.
We actually also are working on the 12-month results right now,
and it's not available to be publicly shared,
but I can say that we did sustain
some of those positive condom outcomes
as far as knowing about condoms
and being confident about obtaining and using them.
So again, please check it out. And thank you.
I guess next slide.
DR. TUITT: Hello. My name is Nicole Tuitt.
I am a Senior Professional Research Associate
with the Centers for American Indian/Alaska Native Health
here in Denver, Colorado,
at the Colorado School of Public Health.
I am here to talk to you about a program
that I was involved with
evaluating the impact of COL, the Circle of Life program,
or mCOL. The "m" stands for multimedia. Next slide, please.
Just a little bit about the Circle of Life program.
It's an evidence-based program
that was originally developed in the 1990s
to address sexual health risks among American Indian teens.
The program was originally developed
specifically for indigenous populations,
so it wasn't necessarily adapted from an original intervention.
It was something that was specifically catered towards,
developed for Native American populations.
In the nineties, it received an extensive amount of input
from Native American health educators, community members
and elders.
In 2010, Office of Minority Health
and a team of members here
from the Center for American Indian/Alaska Native Health
at the University of Colorado adapted the program
to be an online format, which is where the multimedia,
the mCOL title comes in.
The multimedia Circle of Life program
is for American Indian youth ages 10 to 12 years old,
so we're focusing on this younger age group
prior to the onset of sexual risk behaviors,
so before they reach high school
and start to begin to engage in sexual experience.
The program essentially is designed
to increase knowledge and self-efficacy.
These are factors that have been shown
to reduce sexual risk in later years,
so when youth do begin to initiate sex.
We just recently did analyze our data from our study,
and we found that the mCOL program
increases HIV and STI/sexually transmitted infection knowledge.
It increases self-efficacy to avoid peer pressure,
and it also increases self-efficacy to refuse sex
and self-perceived volition.
So we did show that a lot of these
protective precursors to sexual risks
did improve as a result of the Circle of Life program.
The program consists of seven online sessions
that take about 20 minutes each,
and all of our materials are available
at the Healthy Native Youth website. Next slide, please.
When you go to the Healthy Native website,
this is our home page.
You'll have an option to choose whether or not
you're a student or whether or not you're a teacher.
If you were to select the teacher option,
if you want to move on to the next slide, please,
the teacher option, this is what you'll see.
The teacher option will provide you an overview of the program.
It essentially has all the information that you need
to actually implement the actual program.
There are some tabs on the left-hand side
that are used for navigation.
There's information about the program.
We also have some YouTube videos
that sort of go through each lesson,
go through all the materials that you use, that you'll need
underneath the Teacher Resources tab.
The lesson plans are also located
under the Teacher Resources tab, along with the YouTube videos.
When we tested the program
with the Native Boys and Girls Club with whom we worked
for our curriculum, the leaders actually said
that the YouTube videos were really helpful.
So not only do they have these written materials,
but they have these videos that went step-by-step
of how to implement the actual program.
The actors that are in these videos
are from the respective communities that we worked in,
so that's interesting and engaging as well.
If you want to move on to the next slide, please,
slide 34.
If you were to click the youth option,
this is what you would see.
The last slide showed you what the teachers would see,
and then this slide shows you what the youth will see.
You'll register here.
You'll create a username, your password.
Then you'll select the state that you're from,
and then also the age.
The states correspond with different regional themes
that are used for the background,
so the orientation of the medicine wheel
will be slightly different.
There will be different images
that are unique to respective regions of the country.
If you want to move on to the next slide.
This is essentially what, once you begin the curriculum,
whether or not you're a student or you're a teacher,
you'll get a list of the seven lessons
that are part of the program.
Each lesson includes interactive components,
which makes it best for each person
to go through the program independently.
However, we have had some sites do the program as a group.
They projected it on an overhead group --
and it was just as successful.
This slide lists all the seven programs.
The first three lessons, Lessons 1, 2 and 3,
have to be completed before you can move on
to the other lessons, 4, 5 and 6.
These are essentially the foundational concepts,
sort of the core concepts of the program.
We talk about what the Circle of Life is.
We talk about adolescent development
and making healthy decisions
before moving on to the other section.
I'd like to point out that,
while we do specifically focus on sexual health,
there are some lessons that incorporate
issues around substance use,
because in previous studies that we've done,
we've seen a connection with substance use
and sexual risk-taking,
so it's pretty comprehensive in that sense.
So you'll get both sexual health and substance use.
The last four lessons, you can go through in any order.
You can talk about making choices
or learning about HIV or lessons about the disease,
any order that you would like.
If you want to move on to the next slide, please.
In addition to the lesson plans,
there are also discussion topics that we provide
in the Teachers' Resources area to supplement the lessons.
So what mentors, teachers or group leaders,
whoever's leading the lessons can talk about
in addition to reinforce what is taught
through the actual curriculum -- we provide those.
And then also there are some games for youth to play.
This is an example of one of the games
related to decision-making.
As you can see, all the characters in these games
are Native American.
They are adapted to the specific population.
This is an example of the games.
Essentially all seven lessons that are available -- there's
at least one or two games associated with each lesson.
If you want to move on to the next slide.
This shows an example of what the lesson plans
will actually look like.
This is the cover page of the lesson plan.
We provide the objectives of each lesson.
We provide an overview of the online materials,
so essentially a summary of what the lesson has.
We also create an agenda of how long each section will take
or how long we recommend it to take to stay within
that 20-minute time frame,
which we've found to be most effective
when working with such a young population.
We also have the materials that are needed
to actually implement the lessons.
For this particular one, you'll need lotion and glitter.
This is a fun activity.
Then we also give you pointers
on how to prepare to implement the specific lesson.
For Chapter 4, Lesson 4, we thought that
it was important for you to review the questions
and then things like printing the worksheets out
for youth in advance.
That's a brief summary of what the Circle of Life is about,
and then also the curriculum that's available
on the Healthy Native Youth website.
Thank you.
AMANDA: Hi. My name is Amanda Gaston.
I'm from the Zuni Pueblo in New Mexico.
I think there are two presentations left,
which I'll have to zip through
to make sure we have enough time for the next presenter
and then questions.
This is the newest addition
to the Healthy Native Youth website,
Responding to Concerning Social Media Posts.
Next slide, please.
The new one-hour training is designed for adults
who work with Native youth,
and this includes parents, mentors, teachers, coaches,
health educators.
During our research, youth disclosed
they often view concerning posts online,
but they didn't always know how to respond.
They said they wanted support from trusted adults,
like you guys.
However, when we talked to tribal health educators
about how they felt about this,
only 5% felt adequately prepared to respond.
That's why we created this training,
for any adult who has contact with Native youth,
regardless of their role or experience.
The training will prepare adults to help youth
who post or view concerning posts on social media
and connect them to appropriate services.
Next slide, please.
Emerging research suggests that nearly one-third
of American Indian/Alaska Native youth
see concerning messages on social media
on a daily or weekly basis.
These include posts that express depression, grief,
intent to hurt oneself or intent to hurt others
that have been posted on social media sites
such as Facebook, Instagram, Twitter or Snapchat.
Next slide, please.
As you know, suicide prevention
remains challenging among youth,
as many do not disclose thoughts of suicide
before making an attempt.
However, emerging research suggests
that youth may disclose depressive symptoms
and suicidal ideation via social media.
These public discourses may provide new opportunities
to identify youth at risk
and connect them to appropriate resources and support.
Next slide, please.
These posts are surprisingly common.
Over a quarter of young adults
post references to depression symptoms
on their Facebook profiles.
Next slide, please.
As a trusted adult, our goal is to ensure
that you feel prepared when a young person approaches you
about seeing concerning posts on social media.
Next slide.
This is a screenshot here from a slide in the training.
Included in the one-hour training is a 30-minute video,
and this prepares adults to help youth
by giving them an overview of concerning posts,
stories from families who have experience
with concerning posts on social media and suicide,
interviews from youths and mental health professionals,
as well as the research that went into developing the video,
including recommendations for how to interact with youth
using a three-step plan we call the Viewer Care Plan.
The training is built around the video,
which reviews video highlights.
It provides interactive slides for better attention
and encourages community engagement to support youth
using the Viewer Care Plan to help youth in need.
Just a note that there is language in the video
that may be triggering for folks who watch it,
so we do encourage folks to please
talk with a trusted friend or family member
or a local mental health professional.
We do have a clinical psychologist,
Dr. Ursula Whiteside,
who has been working with the [inaudible] project since 2015,
who is available, and we do list her contact information
on the training.
Next slide, please.
Included in the training are support handouts.
These include an overview for a participant
that gives tips and examples for identifying suicidality
and how to talk about it, along with the Viewer Care Plan.
There's also fliers for receiving
more low-cost and free trainings included as well.
Next slide.
Also included are some THRIVE suicide and bullying brochures
that you can share with youth and folks in your community.
All of the training handouts can be found
under the Resource tab on the training,
and they can be downloaded and printed from there.
Next slide.
Also attached as a resource,
we created a community awareness activity
that you can use to raise awareness about this topic
with youth and adults in your community.
It can be used just about anywhere -- at school events,
at a staff meeting, a tribal council meeting
or at tribal gatherings.
Depending on the amount of time you have,
you can show the concerning post video
or just do the role-play activities
that are described in the activity guide.
We also have a youth activity,
which includes a role-play activity,
but it does not include watching the video.
Next slide, please.
This is just a snippet from the training
on some of the tips that we give for responding.
If someone does come to you with a concern,
we suggest that you try to respond quickly.
This is essentially true if youth reach out to you
via text message.
Give them lots of reassurance
so they know they did the right thing by reaching out to you.
You can say something like,
"I'm so glad you noticed this and shared this with me.
Thanks for coming to me. You're so brave for speaking up."
And then be clear about your role moving forward.
You can say something like,
"I'll follow up with your coach after practice."
"I'll talk to their school counselor
first thing tomorrow morning."
"I'll call their mom now."
"You did the right thing. I'll take it from here."
Most importantly, we stress that you take the responsibility
off the youth to respond.
You are better-equipped to get help than they are.
Last slide.
We also have a YouTube video
which is included in the training,
and this shows what a live text message
between a youth and an adult can look like.
The intention is that adults can see what it looks like to
put the video training and the Viewer Care Plan into action.
Thank you for your time.
Please, of course, share this resource widely and freely.
We know social media is here to stay,
and we want to make sure that we are taking care
of our youth as best as we can.
Thank you very much. Next slide.
DAVID: Thanks, Amanda. Hi there.
My name is David Stephens. I'm a nurse
at the Northwest Portland Area Indian Health Board,
and as Amanda mentioned, social media is here to stay,
and so is text messaging,
and I'm going to be sharing a few projects
that we're working on here at Healthy Native Youth
that we are marketing and sharing
through our sister site, We R Native,
which is directly marketed to Native youth.
As cell phones have become ubiquitous among teens,
text messaging has become a promising tool
to promote adolescent health.
Mobile phones are portable, real-time, affordable,
asynchronous. They're personal. Possess one-to-many capacity.
They're interactive and, above all, convenient and fun.
Given an average text message open rate of 98%
versus just 22% for email
and the anytime/anywhere capability of mobile devices
to receive text messages, interventions delivered via SMS
have the potential to reach an incredibly large audience.
Through our We R Native channel,
we have over 5,000 subscribers that have signed up
to receive weekly health tips,
and we've sent over 417,000 text messages
and received over 17,000 text messages
since moving over to our new service in December of 2016.
This is our weekly health tips text message service
that youth can sign up for by texting NATIVE to 97779.
Next slide, please.
Each month we focus on a national health observance.
For example, last month was a focus on bullying prevention.
We posted a series of messages to improve youths' confidence
intervening in situations of bullying or violence.
The sequence started with a message,
"See bullying? Want to help but don't know how?
Text MORE to learn how to be more than a bystander."
As you can see here, this is the message series
that youth could engage with and learn additional tips.
Next slide, please.
Another one of our focused text message campaigns
has been on wellness,
and the Texting for Physical Fitness program
can be tailored to the interests of the individual.
It can be disseminated broadly
regardless of geographic location
and can be accessed when and where the individual is ready
by texting FITNESS to 97779.
Next slide, please.
Once signed up for this service,
text messages are personalized, and participants
can select either a male or female training buddy
to take part in six wellness challenges.
Next slide, please.
They set a personal wellness goal
and are asked if the challenges and goals were met.
Preliminary results show that about 84%
of all wellness challenges were completed,
and 72% so far have indicated that they've met
their personal wellness goals,
so we're really excited about those numbers.
Next slide.
We offer ways for youth
to further engage in the message series,
and also, in addition to the texts,
we also include emojis and also other multimedia videos
that youth can engage with.
Next slide.
Some of the best practices for text message
also include personalizing those messages
and making sure that the messages don't appear
to be coming from a robot.
We try to make those text messages appear to be coming
directly from their training buddy
and an actual person on the other end.
Next slide.
Participants are also offered daily movement reminders.
Again, preliminary data shows participants
who are more engaged with the text message series
actually show improved outcomes.
Almost 90% of all challenges were met
by subscribers who enrolled in the daily movement reminder.
We try to keep it fun as well with those images,
as you can see. "Plank level" -- that baby is an expert.
Next slide, please.
We also have a Texting for Sexual Health campaign,
which youth can subscribe to by texting CONDOM to 97779.
Subscribers receive a 12-week message series
that has shown to increase condom use
and also improve STD and HIV testing behavior.
Next slide, please.
As this is Native American Heritage Month,
we are encouraging youth that you know
to text ONE NATION to 97779.
Once enrolled, youth are prompted to submit a selfie
and share why we are stronger together,
and they can win up to $75.
On Native American Heritage Day, which is November 24th,
we'll be sharing all of their images
in this Steven Paul Judd collage using #ManyTribesOneNation.
Next slide.
Here are a few ways that youth
can directly engage with We R Native.
Follow us on these different social media channels.
For those weekly health tips, contests and life advice
they can text NATIVE to 97779.
We also offer a community service mini-grant
that is directly for youth.
Youth can apply for up to $475 to make a positive difference
in their community.
Youth can also apply to be a We R Native youth ambassador,
and that application will be opening up in the spring.
Next slide.
Some more ways to get involved as health educators and adults
-- share the site with your community networks.
The URL is HealthyNativeYouth.org.
You could also sign up to receive updates about
the curricula available on the Healthy Native Youth portal.
There's a red bar at the bottom of the home page
that you could enter in your information
and stay connected with us on social media
at Facebook.com/HealthyNativeYouth.
Next slide.
Healthy Native Youth and both the We R Native program
are funded by IHS HIV and Behavioral Health Programs
and also supported in part by
the Secretary's Minority AIDS Initiative Fund.
Next slide.
I want to say thank you all,
and we'll turn it back over to Elton for any questions.
FEMALE: Elton, excuse me. Unfortunately, we can't hear you.
ELTON: I want to thank all the presenters
for their lovely presentations
in honor of Native American Heritage Month,
We're very excited to be able to celebrate
Healthy Native Youth's one-year anniversary as well.
Thank you to our presenters.
We do have several questions here.
The first question is for Tommy.
The question is, "Twenty-three percent male
responded to the text survey.
Is there a reason or theory you can come up with
regarding the comparison between female, over 70%,
and the male respondents?
Surely there's no right answer,
but interesting to see the difference."
TOMMY: Yeah, that's an excellent question.
When I present or when I do these outreach,
it's kind of a trending theme
that females are always the first ones to volunteer,
the first ones to sign up for any contest or messaging
that we offer.
There really is no definite answer in this situation,
just because I always joke that us males
are a little more stubborn,
and we take a little more time to get convinced
to either fill out an eight-page survey
or a one-page survey.
I'm looking at David here.
Through our research and other various messaging campaigns,
it always seems to be the female population
that is more engaging, and that's one thing that
I'm kind of setting the personal goal of,
is getting more males involved in other various campaigns
that we have here.
Again, there is no definite answer.
If I knew it, I would share it.
ELTON: Thank you.
The next question is for Jennifer.
Jennifer, this is a two-part question.
Does Native It's Your Game work well on phones and tablets?
Are the youth supposed to be all in the same room
when they do Native It's Your Game?
JENNIFER: Great questions, thank you.
It is not really supported by phones.
We're still working on that,
and hopefully if we get another set of funding
we can fix that.
As far as tablets, they work on all tablets
except for iPads.
We also have some software things
that we're working out there.
So any tablet except for iPads,
and unfortunately not with cell phones.
As far as being in the same room, they don't have to be.
It might be helpful just going through a classroom experience
and to be able to monitor and make sure
that they don't have any questions, aren't getting stuck
or aren't on other websites.
But it's definitely not a necessity
that they're all in the same room.
ELTON: Okay, thank you. Nicole, the next question is for you
for the multimedia Circle of Life curriculum.
How do you define self-efficacy
besides better able to resist peer pressure or refuse sex?
In other words, does it come from a mix
of sexual knowledge and more confidence?
DR. TUITT: Sexual knowledge is actually separate.
Self-efficacy is essentially whether or not
youths have the belief that they can resist sex,
is how we use the definition. Is that helpful for you?
Does that answer your question? Oh, you can't --
ELTON: Yeah, I believe so.
But we can follow up to the questions
if you want a more definitive answer for them.
The next question is for David.
David, did you help develop the monthly text messaging content,
or was that pulled from one source and then delivered?
DAVID: Absolutely. Our program strives to be
for Native youth by Native youth,
so all of our content on the website
has been reviewed by Native youth,
and we have a great group of youth ambassadors
who we frequently poll for that content
and bounce ideas off of as well.
The monthly focus of those national health observances
is a mix of both medically accurate resources and
trusted resources in addition to youth-reviewed content.
ELTON: It's time for winding down.
We have our last question for Stephanie.
For the concerning post trainings,
how do you address the gap between youth who participate
in the training but reach out to an adult
who has not received the training?
DR. RUSHING: That's a great question.
We're going at it from two angles.
We are both educating youth to reach out
if they see concerning posts
and also, through the webinar that Amanda spoke about,
equipping adults to respond to those situations.
To prepare youth to raise the issue
when they see concerning posts, we have been using
the text messaging service and We R Native's Facebook page
to encourage young people, if they see concerning posts,
to reach out to trusted adults
and giving them some steps and tips
to not judge those concerning posts about whether it's true
or drama, but take everything seriously and report it.
And through Amanda's concerning posts training
equipping parents and adults to use the Viewer Care Plan
to help youth who are in those situations.
ELTON: Thank you. And thank you again
to all our presenters who were able to present
on Healthy Native Youth.
Please reach out to the information
for the Healthy Native Youth project online,
Twitter or social media,
and also for the Office of Minority Health Resource Center.
Again, thank you for everyone who was able to participate
on this webinar.
We were honored to be able to celebrate
Native American Heritage Month with this webinar,
and continued success on the project
and the good work that everyone's doing
for our Native youth in our Native communities.
Thank you again. Yeah!
FEMALE: Hooray!
FEMALE: Thank you, everyone. [laughing]
MALE: Thank you, everyone. MALE: Thank you all.
FEMALE: Thanks for coming. FEMALE: Thank you.
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