The national obesity epidemic is disproportionately affecting Native American children. Obesity rates are 31.2% for Native preschoolers, significantly higher than other racial/ethnic groups, especially non-Hispanic White or Asian children, 12.8% of whom are obese.

This presentation will summarize the use of community partnerships as a method for solving the complex problem of childhood obesity on a Native American reservation. The Communities at Play program came to fruition with the partnership of researchers from the University, staff at a Tribal College, Tribal Health Department and community leaders. In an effort to use community collaboration to combat childhood obesity, the CAP project has four primary aims: 1) Develop partnerships, 2) Determine a collaborative agenda, 3) Educate the public, and 4) Evaluate the project.

As part of the second aim, The CAP leadership team completed a Community Readiness Assessment in six towns on the Native American Reservation. Although some members recognize childhood obesity as a problem, there exists a vague overall awareness and therefore little community motivation to do anything about it.

In order to increase community awareness and motivation, the leadership team sees a need to focus work toward fulfilling the third aim by increasing efforts to educate the public. Educational materials will include information about childhood obesity on the reservation, the results of the Community Readiness Assessment, and steps to reduce childhood obesity. To refine the content and clarity of all educational materials, we will undergo a two-part revision process. Part one will consist of an internal review of materials, and part two will include input from a focus group of area adult parents and guardians.

By doing a thorough internal revision followed by small focus groups of area parents, we will be able to improve the effectiveness of educational media and ensure we are communicating in a way that will lead toward increased reduction of child obesity. Raising awareness of the problem and its solutions will lead to increased community involvement and engagement, and facilitate the implementation of future interventions.

Children and adolescents who are impacted by HIV are a vulnerable and vastly understudied population. This is one of the first studies to research mental health issues faced by youth with HIV and to explore the link between HIV and mental health in those between the ages of 8 and 19. Norm-referenced measures of psychological issues were collected from a sample of youth, who are infected with HIV and affected by HIV (i.e., have an infected family member). This topic is relevant to those outside of the discipline of psychology because it highlights the impact of chronic illness on the functioning of youth. Further, a goal of this project is to decrease stigma and increase awareness about youth in the United States who are impacted by HIV.

HIV is now considered a chronic illness due to advances in medical treatment, and there has been limited research into the mental health problems that can arise from living with HIV, particularly among youth. Past research has demonstrated that posttraumatic stress disorder can be a result of experiences related to chronic illness. The present study will examine the mental health issues faced by both HIV-positive youth and those who are affected by HIV, specifically the extent to which they experience traumatic events.

Data collection for this project was completed in collaboration with a nonprofit organization that runs a camp for youth who are impacted by HIV. The camp coordinator assisted the first author with data collection by distributing hardcopy packets of study measures to a mailing list of camp participants. Additionally, an online survey link was distributed via a camp listserv. Deidentified data was returned to the first author for analysis.

This study is the first to the author’s knowledge to examine the relation between posttraumatic stress and HIV in youth under the age of 18. Results include measures of trauma exposure and symptoms and symptoms of anxiety, depression, and distress. For instance, youth impacted by HIV reported experiencing an average of 5.2 traumatic events, including both HIV- and non-HIV-related events. The most commonly reported traumatic event was receiving the HIV diagnosis of someone close to the participant (74.3%), and 50% of participants have experienced the death of someone close to them as a result of HIV/AIDS.

Given the scarcity of research among youth who are impacted by HIV, the present study will contribute to the field in several ways. Patient care may be enhanced by informing education initiatives that enrich care professionals’ awareness of the potential link between HIV, posttraumatic stress, and other mental health issues in youth and how to identify vulnerability, offer follow-up, and refer patients for specialist psychological treatment (Theuninck et al., 2010). Further, both parents and youth will benefit from education to help those impacted by HIV to recognize their vulnerability and identify posttraumatic stress symptoms (Theuninck et al., 2010). Findings from the study may benefit the nonprofit organization relative to their programming and treatment offerings.

Developing Community Partnerships to Promote Breastfeeding on the Flathead Indian Reservation

Amy Stiffarm, cMPH¹, The Breastfeeding Coalition of the Mission Valley², Kari Harris, Ph.D¹, Emily Colomeda, MPH, RN²

¹School of Public and Community Health Sciences, University of Montana, Missoula, MT. ²Lake County Public Health Department, Polson, MT.

Breastfeeding has many known health benefits for the growth and development of infants. It has been shown to reduce the risks for asthma, leukemia, obesity, ear infections, diarrhea, vomiting, lower respiratory infections, sudden infant death syndrome (SIDS), and others. (Office on Women’s Health, 2014) The World Health Organization recommends exclusive breastfeeding for infants up to six months of age, with continued breastfeeding for up to two years of age or beyond. (WHO, 2016) As of 2012, only 10% of American Indian infants had met those requirements, (Goldhammer, 2014) suggesting the need for innovative approaches.

It is the aim of the Breastfeeding Coalition of the Mission Valley (BCMV) and other breastfeeding advocacy groups to help create awareness about the importance of breastfeeding and support mothers who wish to breastfeed. The purpose of the work reported here was to assist the BCMV in re-organizing and providing a new structure for the coalition. This was in an effort to encourage pregnant women to breastfeed and support breastfeeding mothers on the Flathead Indian Reservation. Currently, the BCMV is the only breastfeeding coalition in Montana located on an American Indian Reservation.

There are many barriers to starting and sustaining breastfeeding. Some barriers for the general population include, lack of support and acceptance by family, friends, and community and not enough breastfeeding-friendly public places. These barriers are true for the Native population as well. Additional barriers for Native American women in Montana are the lack of models, lactation consultants, and breastfeeding support groups on reservations.

Community partnerships, local supporters, and a small grant from the Montana State Breastfeeding Coalition allowed the coalition to host its first ever outreach event in honor of World Breastfeeding Day during the annual Standing Arrow Powwow in the summer of 2015. This outreach event served as an intervention to address the public health concern of Native mothers discontinuing breastfeeding too soon. The BCMV set up a breastfeeding support space through out the powwow where mothers could come nurse comfortably in the shade, while still being able to enjoy the powwow. The powwow committee provided water to all moms who used the area, a diaper changing station was made available to all moms who needed it, and educational material was made available for mothers and pregnant women.

While approximately five mothers used the space to breastfeed, over 10 mothers did use the diaper changing station. More importantly, the support space contributed to the to the normalization of breastfeeding, which was an additional aim of the intervention. The powwow committee was grateful for BCMV’s presence at their event and invited them back next year. Consistency in the support and the promotion of breastfeeding will help to further normalize breastfeeding. In future years it is expected that more mothers will utilize the breastfeeding support space. The BCMV is continually seeking ways to best meet the needs of breastfeeding mothers.