# We are here now - a multi-level, multi-component sexual and reproductive health intervention for American Indian youth

> **NIH NIH R01** · MONTANA STATE UNIVERSITY - BOZEMAN · 2020 · $621,479

## Abstract

Project Summary/Abstract
American Indian (AI) communities in the United States (US) are disproportionately affected by sexual and
reproductive health disparities, compared to other populations, placing current and future generations of AI
societies in jeopardy. Our study, “Nen ŨnkUmbi/EdaHiYedo (N/E - “We are Here Now”)”, utilizes a culturally
tailored ecological intervention in which the prevention of sexual-risk behaviors among AI youth that lead to
STIs, HIV, HCV, and teen pregnancy are addressed. N/E takes place on the Fort Peck Reservation in
northeastern Montana. N/E is a community-based participatory research sexual and reproductive health (SRH)
intervention, constructed on Ecological Systems Theory. Based on Fort Peck tribal members' desire to
implement a holistic SRH intervention for the tribes' youth, N/E includes: 1) A school-based SRH curriculum
called Native Stand, designed to address individual-level factors that lead to risky behaviors; 2) a family-level
curriculum called Native Voices, tailored to increase communication between adult family members and youth
about SRH topics; 3) a cultural mentoring component at the community-level that pairs AI youth with adults and
elders to discuss traditional AI beliefs and practices about SRH; and 4) a systems-level strategy to activate a
multi-sectoral network of local youth servicing organizations to coordinate SRH services. The overarching aim
of this proposal is to refine and tailor the components of N/E and evaluate its efficacy. N/E is a 5-year study
involving 456 15- to 18-year-old AI youth and their parent/legal guardian. AIM 1 begins with a year of formative
work to refine and tailor the components of N/E. Our community advisory board and the Fort Peck-based and
MSU-based research team will design culturally appropriate adaptations for N/E's 4 levels. AIM 2 tests the
efficacy of N/E using a cluster-randomized stepped-wedge design (SWD), in which the 5 high schools that Fort
Peck youth attend are randomized into the intervention 1 at a time. N/E's primary outcome is increased
condom use during sexual intercourse. Secondary outcomes are delayed onset of sexual intercourse, number
of sex partners, frequency of sexual intercourse, pregnancy history, consistent use of birth control during
sexual intercourse, and whether alcohol and/or other drugs are used during sexual intercourse. Tertiary
outcomes are increased parent/legal guardian-child communication about SRH topics, increased
understanding of cultural values related to traditional AI beliefs regarding SRH, and increased use of SRH
services. Quantitative data collection includes: student surveys at baseline, 3, 9 and 12 months; parent/legal
guardian surveys at baseline, 9 and 12 months. Qualitative data collection includes SRH service provider
discussion groups at baseline and thereafter once a year over the 5-year study, with logs to track coordination
and implementation at baseline and 3, 6, 9 and 12 months. AIM 3 will evaluate the...

## Key facts

- **NIH application ID:** 9828501
- **Project number:** 5R01MD012761-03
- **Recipient organization:** MONTANA STATE UNIVERSITY - BOZEMAN
- **Principal Investigator:** Elizabeth Lynne Rink
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $621,479
- **Award type:** 5
- **Project period:** 2018-04-01 → 2022-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9828501

## Citation

> US National Institutes of Health, RePORTER application 9828501, We are here now - a multi-level, multi-component sexual and reproductive health intervention for American Indian youth (5R01MD012761-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9828501. Licensed CC0.

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