METHODS
Qualitative research methods were chosen for this study to capture Northern Plains AI’s unique points of view.
32-34 The use of qualitative methods is important when working with AI participants, as cultural elements are best revealed and understood through open-ended methods.
32,35-37 Prior to conducting this study, all study procedures were approved by institutional review boards and by the local tribe through a tribal resolution for the reservation site.
Tribal anonymity is required; therefore the specific tribal community is not identified in this study.
Data collection occurred at one reservation site where almost all participants indicated one tribal affiliation and one small, urban site with participants who indicated various tribal affiliations.
Data were gathered from a diverse range of perspectives using: (1) focus groups with AI youth (parents and nonparents aged 16 to 25 years old) and elders (aged 40 or older), with 5 to 11 participants per group and stratified by age, sex, and parental status; and (2) one-on-one key informant interviews with healthcare providers and high school personnel from health facilities/high schools with a high representation of AI patients/students.
The focus groups and key informant interviews had similar questions and were facilitated by the local community research associates hired for this project.
The formulation of focus group and interview questions were the result of collaborative efforts among study staff and the communities involved such that, throughout all phases of the research process, community advisory boards consisting of local AI individuals were consulted in the development of data collection instruments and implementation of project protocol.
Measures focused on cultural influences, social norms, access to reproductive services, adolescent sexual risk behaviors, and contraceptive use.
Local community research associates recruited participants by means of flyers, community contacts, and word of mouth. The focus groups and interviews were conducted in private rooms at local community health buildings or libraries.
Written consent or assent was obtained from all participants, and parental consent was obtained for participants younger than 18 years of age.
Participants were offered a $40 gift card to a retail store for their participation in the focus group or interview.
The focus groups and interviews were taperecorded and transcribed verbatim.