na sister gorman
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By Beatrice Norton (Hopi Tribe), Frances Cupis (Pascua Yaqui Tribe), and Gwenda Gorman (ITCA)
NA SISTER: Sharing Outcomes of a three-year
HIV/AIDS Prevention Project
Overview
• Background – Statistics/SISTA
• Partnerships
• Adaptation Process/Tailoring to Tribes
• Results
• Next Steps
Background
• America Indians/Alaska Natives (AI/AN) in AZ have the second highest Chlamydia and Gonorrhea rates in Arizona among 10-19 years old and adults
• AI/AN in AZ have the third highest HIV/AIDS rates
• The ITCA received a three-year grant from the Office of Women’s Health to adapt the evidence-based intervention, Sisters Informing Sisters on Topics About AIDS (SISTA) for American Indian women in Arizona
SISTA
Incorporates
• Discussions and activities to empower women to praise their strengths and identify role models in their communities.
• Risk reduction skills building.
• Take home assignments that includes their partners participation.
SISTA
• Original curriculum targeted African-American heterosexual women
• A group-based evidenced-based intervention
• Includes 5, two-hour sessions, with two optional booster sessionsSession 1: Ethnic and Gender PrideSession 2: HIV/AIDS EducationSession 3: Assertiveness Skills TrainingSession 4: Behavioral Self-Management Session 5: Coping Skills
SISTA
Women who completed the SISTA intervention reported:• Increased consistent condom use.• Greater sexual self control.• Greater sexual communication.• Greater sexual assertiveness.• Increased partners’ adoption of norms supporting consistent condom use.
Project Goal
To provide culturally appropriate HIV/AIDS prevention education to AI/AN women in Arizona, through adapting, tailoring, and implementing the Sisters Informing Sisters on Topics about AIDS (SISTA) Project.
Collaboration
Adaptation Process
• Two women were identified from each tribal site to participate in a four-day SISTA Facilitator Training by CDC in May of 2010.
• Face to face meetings were held with the tribes on further discussion of adaptation steps.
• Each tribe conducted feedback sessions and key informant interviews on how to implement the project in their respective communities.
Adaptation Process
• Recruited at least 40 women American Indian women to receive sessions from original curriculum.
• Women received gifts cards for participating in the sessions and were offered an additional gift card for voluntarily getting an HIV/STD test.
• Feedback from participants were recorded to make changes to new curriculum, Native American Sister Informing Sister: Educating, Talking, and Reducing Risk.
Adaptation Process
• Capacity building activities were provided to facilitators (i.e. Program Evaluation, Effective Facilitation Skills)
• Facilitator Training on the new NA SISTER curriculum held in Phoenix, AZ
• Facilitator observations were conducted to ensure fidelity of curriculum
NA SISTER
• Targets American Indian women
• Group based intervention with six sessions:Historical Trauma and Cultural Resilience session added (based on literature review conducted and feedback)
• American Indian poems added and activities and role play scenarios were changed
• Modified “SISTAS Assertiveness Model” acronym to “SISTER Proactive Communication Model”
• New design cover for curriculum
Tailoring to Tribes - Hopi
NATIVE AMERICAN SISTER PROJECT
Na'na tupkom na'nami tunat yaw yungwa(Sisters helping to protect one another….)
ADAPTATIONS: Motto: Women’s Journey Opening Poem: Written by Hopi woman Values worksheet: Corn Plant Values Sheet At the Parking Lot: At the PIKI HOUSE Props : Cultural items defining Hopi women’s significance in the Hopi Cultural
Tailoring to Tribes - Hopi
Tailoring to Tribes – Pascua Yaqui Tribe
• Collaborated with the Language and Culture Department and Elders from tribal communities to assist in curriculum development of traditional learning techniques.
• Utilized the Language and Culture Department regarding ceremonial direction in spirituality, historical trauma and cultural resiliency.
• Utilized our Hiaki language to adapt the Sewa Hamut Program from NA SISTERS to provide connection with community.
• Integration of symbolism of Sewa Hamut or flower women has a connection to nature, culture and health.
Sewa Hamut Program – RESPECT FOR MY COMMUNITY, MY TRIBE, MY LIFE.
Tailoring to Tribes – Pascua Yaqui Tribe
ResultsNA-SISTER Preliminary Evaluation Select Findings
NA-SISTER Preliminary Evaluation Select Findings
Age Group of Participants (in years)Health & STI Screenings
– 91% reported Pap Test– 41% reported Chlamydia– 26% reported Gonorrhea– 53% reported HIV test
Note: These are self-reported from the pre-tests
Confidence or Self-efficacy (Condoms)
Highest Post-testHighest Pre-test
Increased Intention to Use Condoms (Next Time)
Increased Intention to Use Condoms (Next 3 Months)
Almost 12% increase
Next Steps
• Share findings of project outcomes with tribes
• Provide Facilitators Training on NA SISTER curriculum (dependent on additional funding)
• Share curriculum with other tribes
• Identify other funding sources to continue project
Questions?