Other Titles

An Adaptive Greater Resilience Information Toolkit as a Transformative Strategy for Native American Women [Title Slide]

Abstract

Background/Purpose: Native Americans (NAs) exhibit lower quality of life due to poverty, inadequate health services, historica/ongoing discrimination. NA women are underrepresented when it comes to the epidemic of violence, mental health and wellness outcomes.The purpose of this mixed method study was to explore the relationship between Native American (NA) women cultural beliefs, attitudes, and perceptions by gathering cultural input on the Greater Resilience Information Toolkit (GRIT) program.

Methods: This is a mixed-method community-based participatory research (CBPR) study. Self-efficacy is the theoretical framework. Upon Institutional Review Board approvals, flyers were posted at the tribal wellness center. Prior to focus groups, participants were consented and quantitative data was collected. The quantitative method was examined using the following: 1) Demographics, 2) Social Determinants of Health [SDOH], 3) Perceived Stress Scale, 4) Awareness of Connectedness Scale, and 5) The Wiconzani Instrument. For the qualitative method, cultural input on the GRIT was evaluated using semi-structured interviews in face-to-face focus groups.

Results: A total of 14 individuals participated in a primary and follow-up focus group. The mean age was 34 years old, all identified as female, 50% live with a partner, 35.7% never married, 64.3% high school, 28.6% some college. Total family income is < than $10K, 78.6% run out of money every month, 64.3% can’t pay the basics like food, housing, medical care and heating, 28.6% smoke 1-3 pks/day, 57.1% lack transportation, 35.7% emotionally abused, 21.4% physical hurt/kicked, 57.1% depression. 60% feel family hurts with them, 70% feel family’s happiness is theirs too, 30% feel community believes in them and 60% feel community’s happiness is theirs. Physical health is rated as 35.7% below average, 57.1% rate spiritual health as average, 71.4% rate mental health is important to quality of life. Qualitative: change self-efficacy to self-confidence, use native terms. Use smudging/prayers. Include cultural practices such as storytelling and use of native language. “Stand up for somebody…Stay humble. Yeah. One person's struggle could be your struggle, too.”

Nursing Implications: Although NA women live below the poverty level, they expressed a positive outlook and connection to nature. This validates the importance of cultural awareness and the promotion of healthy behaviors among NA women and Indigenous women around the world.

Notes

References:

Abbott, K. M., Boyens, B. M. S., & Gubbels, J. A. A. (2022). Intergenerational Talking Circles Exploring Psychosocial Stressors for Preterm
Birth and Strategies for Resilience among American Indian Women. Journal of Transcultural Nursing, 33(3):268–277.

Abdulsalam, R., O’Connell, J., Jiang, L., & Grau, L. (2023). The relationship between social determinants of health and hospitalization among American Indian and Alaska native older adults with and without dementia. Alzheimer’s & Dementia, 19(S8).

Abigail K. Winiker, A. K., White, S., Candelario, J., Takahashi, L. M., & Tobin, K. E. (2023). “Through the Things That Have Happened to Me, They’ve Made Me Stronger”: Individual and Interpersonal Sources of Violence and Resilience Among a Diverse Sample of Transgender Women in Los Angeles. Journal of Interpersonal Violence, 38(5-6):5019–5043.

Christensen, L., & Damon, S. (2022). Social Determinants of health and response to disease associated with health outcomes of American Indian and Alaska native patients. JAMA Network Open, 5(3).

McKinley, C. E., Boel-Studt, S., Renner, L. M., & Figley, C. R. (2021). Risk and protective factors for symptoms of depression and anxiety among American Indians: Understanding the roles of resilience and trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 13(1):16– 25.

Taylor, J. Y., Barcelona, V., Magny-Normilus, C., Wright, M. L., Jones-Patten, A., Prescott, L., Potts-Thompson, S., & Santos, H. P. (2023). A roadmap for Social Determinants of Health and Biological Nursing Research in the National Institute of Nursing Research 2022–2026 strategic plan: Optimizing health and advancing health equity using antiracist framing. Nursing Outlook, 71(6):102059.

Description

Adapting the GRIT program for NA women offers a resiliency strategy aimed at adopting culturally information for a population often underrepresented when it comes to addressing mental and wellness outcomes.

Author Details

Kathy Prue-Owens, PhD, RN; Marie Zephier, MPH; Lauren Shaw, Psy.D; Nicole Weis, MA, LPC, LAC

Sigma Membership

Psi at-Large

Lead Author Affiliation

University of Colorado Colorado Springs, Colorado Springs, Colorado, USA

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Mixed/Multi Method Research

Keywords:

Health Equity or Social Determinants of Health, Global Leadership, DEI/BIPOC, Healthcare Disparities, Native Americans, Women, Special Populations

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-07-24

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Using Greater Resilience Information Toolkit as a Transformative Strategy for Native American Women

Toronto, Ontario, Canada

Background/Purpose: Native Americans (NAs) exhibit lower quality of life due to poverty, inadequate health services, historica/ongoing discrimination. NA women are underrepresented when it comes to the epidemic of violence, mental health and wellness outcomes.The purpose of this mixed method study was to explore the relationship between Native American (NA) women cultural beliefs, attitudes, and perceptions by gathering cultural input on the Greater Resilience Information Toolkit (GRIT) program.

Methods: This is a mixed-method community-based participatory research (CBPR) study. Self-efficacy is the theoretical framework. Upon Institutional Review Board approvals, flyers were posted at the tribal wellness center. Prior to focus groups, participants were consented and quantitative data was collected. The quantitative method was examined using the following: 1) Demographics, 2) Social Determinants of Health [SDOH], 3) Perceived Stress Scale, 4) Awareness of Connectedness Scale, and 5) The Wiconzani Instrument. For the qualitative method, cultural input on the GRIT was evaluated using semi-structured interviews in face-to-face focus groups.

Results: A total of 14 individuals participated in a primary and follow-up focus group. The mean age was 34 years old, all identified as female, 50% live with a partner, 35.7% never married, 64.3% high school, 28.6% some college. Total family income is < than $10K, 78.6% run out of money every month, 64.3% can’t pay the basics like food, housing, medical care and heating, 28.6% smoke 1-3 pks/day, 57.1% lack transportation, 35.7% emotionally abused, 21.4% physical hurt/kicked, 57.1% depression. 60% feel family hurts with them, 70% feel family’s happiness is theirs too, 30% feel community believes in them and 60% feel community’s happiness is theirs. Physical health is rated as 35.7% below average, 57.1% rate spiritual health as average, 71.4% rate mental health is important to quality of life. Qualitative: change self-efficacy to self-confidence, use native terms. Use smudging/prayers. Include cultural practices such as storytelling and use of native language. “Stand up for somebody…Stay humble. Yeah. One person's struggle could be your struggle, too.”

Nursing Implications: Although NA women live below the poverty level, they expressed a positive outlook and connection to nature. This validates the importance of cultural awareness and the promotion of healthy behaviors among NA women and Indigenous women around the world.