Exploring Urban American Indian Parents’ Feedback to Ensure Relevance of a Culturally Adapted Parenting Intervention, Parenting in 2 Worlds

Although over 70% of American Indians (AIs) live off reservations and in urban areas, there is a dearth of research exploring culturally-adapted health interventions that reflect their lived experience in the contemporary urban environment. This is important as interventions that may have significant effects with other racial/ethnic groups may not necessarily have similar effects with AIs due to differences in culture. This paper utilizes participants’ evaluations of Parenting in 2 Worlds (P2W), a culturally-adapted parenting prevention intervention for urban AI families, to explore if P2Wis relevant to and reflective of their parenting experiences in the urban environment, and whether it resonates with their cultural heritage.

Feedback data come from completed post-tests of the urban AI parents (n=363) consenting to participate in either P2W or the comparison curriculum, Healthy Families in 2 Worlds (HF2W). To assess overall impressions of the curricula, three mean scales were created: Overall satisfaction (α=.93), Overall thoughts (α=.94), and Usefulness (α=.65). Participants were also asked to rate on a Likert-scale how much they learned about various specific aspects of the curriculum (e.g. about yourself, about parenting). P2Wparents responded to a single open-ended free-text question, “Write the most important thing you learned from these workshops?” T-tests analyzed differences between intervention groups on the quantitative measures, and the open-ended free-text question was analyzed through a four-step qualitative iterative process.

Results showed no statistically significant differences between the two groups in Overall satisfaction, Overall thoughts, and Usefulness. Responses on these scales were generally quite positive. However, when parents were asked about specific aspects learned, differences between the groups emerged. P2W parents reported statistically higher scores than HF2W parents on how much they learned about themselves, family, culture, parenting, family communication, and substance use prevention. The qualitative analysis revealed six themes: communication; parenting; risky adolescent behavior; family; social support; and norms, traditions, and values. Patterns in these responses mirrored concepts and topics directly taught in the P2Wcurriculum.

Urban AI parents quantitatively and qualitatively demonstrated that having a culturally-adapted parenting program, P2W, does resonates with and responds to the cultural ways which AI families function in the urban environment. Having participants evaluate an intervention both quantitatively and qualitatively is vitally important to ensure that community voice in the research process is heard and to determine the meaningfulness and cultural relevance of an intervention.