586 - Promoting Mental Health Equity for Children Living on a Northern Plains Indian Reservation Through School-Based Health Clinics and Community-Based Participatory Research

Most American Indian and Alaska Native (AI/AN) children experience mental wellness, yet the rates of depression, anxiety, suicide, and substance use of AI/AN youth are disproportionately high compared to White peers. Historical cultural losses and trauma are some of the complex factors affecting the mental health of AI/AN youth. The Health Promotion Disease Prevention (HPDP) tribal program was developed to improve access to culturally informed, quality healthcare for all people living on a Northern Plains Indian Reservation.

Objective:

This poster describes how HPDP’s multidisciplinary school-based health clinics facilitated partnerships for two community-based participatory research (CBPR) studies about resilience in children living on the Reservation.

Design/Methods:

Using the CBPR approach, two study teams completed research at individual schools with the engagement of community advisory boards of parents, teachers, and community members.

Study A was a pre-/post-test single case study design that evaluated a trauma-informed and culturally responsive classroom-level intervention to build student resilience and increase teacher capacity to mitigate educational trauma. Fifty-seven third-grade children and their teachers of a k-3 grade elementary participated for one school year. The intervention included lessons on mindfulness, nutrition, cultural values, art, and resilience. 

Study B was a theory-driven, convergent, mixed methods study to explore the resilience of children (ages 6-13) attending a k-8 school. Forty-seven children and their guardians completed a version of Child Youth Resilience Measure-Revised. A subset of twenty of these children also participated in a 15-minute semi-structured interview.

Results:

After implementation of Study A, teacher-student relationships improved on the Classroom Assessment Scoring System (CLASS) evaluation protocol (p< .001), which resulted in 27% fewer children referred to the office for punitive practices. Students reported increased ability to self-regulate using mindfulness, persisting through difficult tasks, and reaching out for help from peers and adults.

Study B found that relational/caregiver related resilience was significantly higher than personal resilience in this group of children. Caregivers on average scored their children higher in resilience than children scored themselves. Six themes of resilience were identified.

Conclusion(s):

The findings about cultural resilience and classroom interventions on this Reservation will inform healthcare and policy to improve mental health outcomes in AI/AN children.