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Abstract: Suicide and alcohol use disorders are significant Alaska Native health disparities, yet there is limited understanding of protection and no studies about social network factors in protection in this or other populations. The Qungasvik intervention enhances protective factors from suicide and alcohol use disorders through activities grounded in Yup'ik cultural practices and values.
Identification of social network factors associated with protection within the cultural context of these tight, close knit, and high density rural Yup'ik Alaska Native communities in southwest Alaska can help identify effective prevention strategies for suicide and alcohol use disorder risk. Using data from ego-centered social network and protective factors from suicide and alcohol use disorders surveys with 50 Yup'ik adolescents, we provide descriptive data on structural and network composition variables, identify key network variables that explain major proportions of the variance in a four principal component structure of these network variables, and demonstrate the utility of these key network variables as predictors of family and community protective factors from suicide and alcohol use disorder risk.
Connections to adults and connections to elders, but not peer connections, emerged as predictors of family and community level protection, suggesting these network factors as important intervention targets for intervention. Resumen: El suicido y los trastornos en el consumo de alcohol son disparidades de salud significativas entre los nativos de Alaska. Con datos de redes egocéntricas e indicadores de encuesta sobre los factores how does risk relate to potential return contra el suicidio what are the important factors in a relationship el abuso de alcohol en 50 adolescentes Yup'ik, proporcionamos datos descriptivos de las variables de composición y estructura de la red, identificamos aquellas variables claves de la red social que explican una mayor proporción de la varianza en la estructura de cuatro componentes principales de dichas variables, y demostramos la utilidad de dichos indicadores como predictores de los factores familiares y comunitarios de protección contra el suicidio y el riesgo de consumo abusivo de alcohol.
Las conexiones what are the important factors in a relationship adultos y las conexiones con ancianos, pero no las conexiones con iguales, emergieron como predictores de la protección a nivel familiar y comunitario, lo que sugiere que estos factores de la red son un objetivo importante de la intervención. Relación de la red social con los factores protectores del sucidio: Intervención en los trastornos de consumo de alcohol de jóvenes nativos Yup'ik de Alaska.
Suicide and alcohol use disorders are significant health disparities experienced by Alaska Native people, with youth, and male youth what are the important factors in a relationship particular, at significantly higher risk for death by suicide and alcohol related problems, in contrast to their age cohort in the U. The resulting Qungasvik toolbox intervention is an adaptive intervention. Each community selects from a set of modules that create protective experiences for youth on the individual, family, and community levels against suicide and alcohol use disorder.
The What are the important factors in a relationship intervention represents the results of a community-based participatory research CBPR intervention development process grounded in Yup'ik protective factors model. Describe the relationship between banker and customer intervention is strengths based, and instead of adopting a risk reduction approach, seeks to increase protective factors believed to mediate suicide and alcohol use disorder risk.
A culturally grounded protective factors theoretical model for prevention of suicide and alcohol use disorder risk in Alaska Native youth guides the Qungasvik intervention. The protective factors model was derived from qualitative work that generated a does a database need a primary key model of what are the important factors in a relationship factors Allen et al.
RFL and RP are co-occurring strengths-based ultimate outcome variables for the Qungasvik intervention. The individual, family, and community protective factors predictor variables of RFL and RP function as intermediate prevention strategy target variables in the culturally grounded theoretical model guiding the Qungasvik multilevel intervention.
Qungasvik as a multilevel intervention has numerous modules at the community and family levels that seek to enhance protection through its strengths-based model. Previous research has identified intervention dose related growth in measures of these intermediate intervention target protective factors hypothesized in the theory of change to be responsible for the Qungasvik intervention effects Mohatt et al. However, despite our observations, in conducting the intervention, regarding its impacts on community and family functioning and their network structures, we understand little regarding the relationship of the social networks within these geographically remote, tight knit, kinship-based Yup'ik rural communities to these protective factor variables.
Enhanced understanding of social network variables important in protection could guide more effective intervention efforts in our work in these communities. At present, there is similarly no published data providing even basic description of the potentially distinctive characteristics of the social networks in remote Alaskan Indigenous communities. However, the majority of this research is focused on risk, and few studies in the literature explore the relation of network variables for protection.
Compositional variables focus on actors or relationships' attributes, or to the type of resources to which actors have access, and include such things as homophilywhich is the extent to which similar actors associate, boundary densityor the extent to which actors associate across sub-networks, as well as numerical counts of relationships with certain attributes. Preliminary results of an ongoing clinical trial in 40 US high schools testing Sources of Strength, a universal youth suicide prevention program Wyman et al.
Social isolation and intransitive friendship networks associate with increased suicide attempt, and maladaptive attitudes in space diagram simple definition networks i. These preliminary data also found that a peer network with more adult ties and positive norms increased youth help-seeking for distress and suicidality, which is typically very low among adolescents Wilson, Centers for Disease Control and Prevention,we could locate no studies exploring social network variable relationships to suicide risk or protection in this population.
While the relation of peer social networks to adolescent alcohol use has been studied among other populations, limited research has been conducted with American Indian and Alaska Native youth. To date, we could locate no study that has explored social network effects on alcohol initiation with American Indian or Alaska Native youth. While network effects what does dtf stand for in law enforcement alcohol use disorder risk have been studied in the general literature, we could locate no study that has explored peer relations and patterns of protection from alcohol.
Study of protection and the growth mechanisms of protective factors among youth is an important research question for alcohol prevention science. One nationwide school study has been conducted with American Indian youth. Rees, Freng, and Winfree found fewer ties to in-school friends among American Indians in comparison to White youth, and that level of activities with friends, as well as number of drinking friends in a youth's network increased self-reported social and physical negative consequences of alcohol consumption, whereas parental connectedness decreased consequences.
These results are generally compatible with network theories based on Durkheim Bearman,in which a good balance of social integration, reflected by network density, and social regulation, represented by a network composition insuring homogeneous and positive norms, are protective from suicide and facilitative of other positive health outcomes, including protection from alcohol use disorders.
In the current study, we describe the youth social networks of a rural Yup'ik Alaska Native community in southwest Alaska in order to evaluate the extent to which network statistics are predictive of protective factors from suicide and alcohol use disorder risk. This can allow for identification of social network variables potentially relevant to protection, suggesting targets for intervention, as well as indices by which to assess key elements within the intervention process of change.
Using data from youth social networks within a Yup'ik cultural context, we address three research objectives: 1 provide descriptive data on structural and composition network variables from youth social networks in a rural Yup'ik Alaska Native cultural context, 2 identify key network variables that explain major proportions of the variance in the principal component structure of these network variables, and 3 explore these key social network variables as predictors of hypothesized protective what are the important factors in a relationship from suicide and alcohol use disorder risk.
Identification of social network factors associated with protection can potentially help identify effective prevention strategies for suicide and alcohol use disorder risk. Participants were recruited from one Yup'ik Alaska Native community in southwest Alaska, where communities range in population from to residents. Participants were Alaska Native youth between ages 12 and All participants described their ethnicity as Yup'ik.
An additional seven participants completed the network survey, providing a larger sample size of 57 for the network descriptive and principal components analysis. Average age of the total sample of 57 was Assessment of outcomes from the intervention includes measures tapping growth in protective factors. This study added a social networks survey to those measures. Participants for the intervention were recruited through presentations to the tribal council and community groups, posters, announcements in school, and direct contacts and invitations to parents and youth.
Written informed consent was obtained in English or Yup'ik from one of the youth's parents and assent was obtained from all youth under age 18, while consent was obtained for youth over age Following this and prior to intervention, the first wave of baseline data collection was conducted. Surveys were administrated in the community school computer lab. We elected to use an ego-centered approach to social network data collection e. An ego-centered approach collects information about each participant's network independently, as opposed to a sociometric approach that collects information on the network of the whole population or group.
Advantages of this ego-centered approach are its comparative logistical simplicity, lower costs, and greater feasibility in comparison to approaches requiring interviewing of an entire community, and its ability to provide anonymity to the alters, as only each ego knows the identity of alters, who are identified only by nicknames. The approach also allows for application of standard statistical methods, as each ego network is independent of the others.
One weakness of the approach is that many statistics pertaining to the whole network e. The complete ego network survey is provided in Supplementary Table S1. Participants started the survey using a name generator procedure, in which participants egos provided nicknames for their relations alters. Then participants provided their own demographic information and attributes ego attributesand their alters' attributes, and then characteristics of their relationships with alters name interpreterand relationships between each pair of alters.
The name generator for alters elicited two types of relationships, for up to 13 alters, who provided social support in the form of: 1 love, and 2 discussing private matters. Nominations could be made for one or both of these types of relationship. Ego connection meaning in tamil described by participants what are the important factors in a relationship age and gender, and alter attributes were age group young child, youth, adult, or elder and gender.
Alter-Alter relationships were evaluated by eliciting whether alters knew each other yes or no. Network what are the important factors in a relationship were calculated independently for each ego network. The Qungasvik intervention outcomes assessment includes a baseline assessment of protective factor measures administered during the same time as the network survey. Manifest variables were defined through subscale scores to avoid under identification in the path modeling described below.
Two baseline administrations of the intervention assessment survey were administered within 9 days of each other and of the network survey. Response format consisted how to ask a girl what shes looking for on tinder an analog slider control with three semantic anchors not at all, somewhat, a lot. Prior to analysis, we converted the continuous slider scale into 20 equal intervals.
The two baseline measures were averaged; 16 missing data points for a total of 4 participants were replaced by the mean value of the corresponding variable. Number of items, coefficient alpha reliabilities, means, standard deviations, and skewness for each subscale are presented in Table 1. This scale was adapted from the Protective Factors scale for Yup'ik adults Allen et al. Three subscales tap opportunities e. This scale includes the cohesion e.
This scale measures mastery, the sense of efficacy in solving life challenges, along with the desire to become a role model for others. Measures of mastery have typically focused on individually focused mastery, and what are the important factors in a relationship the contribution to mastery achieved from successfully joining in problem solving with other significant figures in the social environment. What are the important factors in a relationship family subscale taps belief one can face life's problems successfully through joining with family e.
A third subscale taps wanting to become a role model e. We adopted a three step approach that included 1 calculating common social network statistics from a social support ego network survey, 2 conducting a Principal Component Analysis PCA of these social network variables, interpreting main components capturing the majority of the variance, and 3 conducting a Partial Least Squares Path Modeling PLS-PM analysis of network components predicting protecting factors from suicide and alcohol use disorder.
PLS-PM has a number of advantages in contrast to SEM, making it an attractive alternative for health disparities research, which is a research area that makes small sample work essential Srinivasan et al. PLS-PM requires fewer assumptions, particularly in regard to not having a requirement for normally distributed variables Tenenhaus,thereby making it more likely to converge in small samples research with less potential for introducing bias in its estimates.
All analyses were conducted with the R software, v. In step one, we calculated common network statistics Wasserman, Constraint, effective size, and efficiency were reverse coded so that an increase of the statistic would correspond to an increase in protective factors. In step two, we conducted a PCA of the network statistics obtained in step one, scaled to unit variance. PCA is a multivariate analysis technique that allows reduction of a large number of collinear variables to a limited number of orthogonal components that represent linear combinations of the variables Jolliffe, Generally the first few components explain most of the variance in the data, and if interpretable, the main components can be used in a regression type analysis, or a subset of the original variables that load the highest can be used for a what are the important factors in a relationship analysis, such as PLS-PM.
The relationships between measured manifest variables represent the outer measurement model, and relationships or paths between the latent variables, based on prior knowledge or theory, represent the inner structural model. In PLS-PM, the overall model is fitted using partial least squares, consisting of iterative least square regressions of the inner and outer models; convergence is obtained when the overall residual variance is minimized.
Probability levels for statistical significance for path coefficients were set at the. Supplementary Table S2 provides descriptive statistics for the network variables. Mean network size was 5. Mean degree adult, 2. Mean degree love, 4. The relationship qualifier 'We help each other out' is present in the highest number of alters, 4. The roles with highest means are Parent, 1.
Average satisfaction relationship is highest for Satisfied, 3. Overall satisfaction density is high at 0. Table 2 presents loadings for the top ten loading variables on the first four components in the PCA of network variables.
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