Visual and Performance Art for HIV Prevention with Indigenous Youth in the Northwest Territories and Nunavut: A Mixed-Methods Multiple Case Study

Regions: Inuvialuit Settlement Region, North Slave Region, South Slave Region

Tags: social sciences, sexually transmitted infection, youth, sexual health, art

Principal Investigator: Logie, Carmen (12)
Licence Number: 16027
Organization: Factor-Inwentash Faculty of Social Work, University of Toronto
Licensed Year(s): 2019 2018 2017 2016 2015
Issued: Jan 27, 2017

Objective(s): To explore two arts-based HIV prevention programs that currently work with Northern Indigenous youth in promoting sexual health.

Project Description: The purpose of this project is to evaluate two arts-based human immunodeficiency virus (HIV) prevention programs that currently work with Northern Indigenous youth in promoting sexual health. The first program is FOXY (Fostering Open eXpression among Youth) in the Northwest Territories (NWT) and the second program is the Nunavut Sexual Health Drama Program (SHDP), in Nunavut. Both FOXY and the Nunavut SDHP have been running workshops in Northern communities for several years. FOXY has offered over 40 workshops since 2012, in 20 different communities in the Northwest Territories. These workshops have been facilitated with young women and have covered topics on sexual health, sexuality, and relationships. Since 2012, the Nunavut SDHP has offered workshops that promote positive sexual health and relationships among Northern youth in various communities across Nunavut. Both FOXY and Nunavut SDHP use arts-based approaches in their delivery, for example, drama techniques are used across both programs to facilitate discussion and learning about healthy relationships and making positive choices in realistic sexual health scenarios.

While these two arts-based HIV prevention programs have been implemented for several years, there has been a gap in understanding the long-term impacts of these programs in reducing HIV risk and increasing well-being for Northern Indigenous youth. The main aim of this project is to address this gap by conducting a rigorous longitudinal evaluation of arts-based HIV prevention programs among Northern Indigenous youth using a mixed-method approach of longitudinal survey and longitudinal qualitative interviews.

The objectives of this research are to:
1. explore experiences and conceptualizations of social and structural contexts of HIV vulnerability (e.g. stigma), and protective factors (e.g. empowerment), among Northern Indigenous youth;
2. build capacity and leadership in HIV prevention and research among Northern Indigenous youth;
3. evaluate the effect of arts-based HIV prevention programs on Northern Indigenous youth’s HIV and STI knowledge, cultural connectedness, self-esteem, empowerment and safer sex self-efficacy; and,
4. Promote North-North Indigenous partnership building, knowledge exchange/cross-learning, and capacity building among and between Indigenous community-based HIV prevention programs.

These objectives will be met through a three-phase research project:
Phase 1, Arts-based Intervention and Evaluation: will involve a survey and longitudinal qualitative interviews with Northern Indigenous youth participating in arts-based HIV prevention programs; in the Northwest Territories, FOXY and in Nunavut the Sexual Health Drama Program.
Phase 2, Youth Peer Leadership and Training: longitudinal qualitative interviews with Youth Peer Leaders regarding their participation in training and subsequently in co-facilitating arts-based HIV prevention programs.
Phase 3, Knowledge Translation and Exchange: using participatory action research methods to facilitate knowledge translation and exchange with diverse community stakeholders.

Youth participants of the FOXY program will be invited to participate in the study by completing surveys at three different times: prior to beginning the FOXY program (baseline), after completing the FOXY program (post-intervention) and 12 months after completing the program (follow-up). This longitudinal survey will measure for the primary outcome of HIV knowledge using the Brief HIV Knowledge Questionnaire. Secondary outcomes that will be measured include: 1) resilience, using The Child and Youth Resilience Measure-28, 2) self-esteem, assessed using the Rosenberg Self-Esteem Scale; 3) empowerment using the Empowerment Measure that assesses power within (e.g. confidence), power to (e.g. relationship dynamics) and power with (e.g. social membership), 4) safer-sex self-efficacy using the Safer Sex Self-Efficacy Scale [21] and 5) cultural connectedness using the Awareness of Connectedness Scale developed to assess culture-specific factors with Alaska Native Youth.

For the longitudinal qualitative interviews we will randomly sample 30 FOXY participants and invite them to take part in in-depth individual interviews at two different times: post-intervention and at the 12-month follow-up. Longitudinal qualitative research (LQR) is often embedded in mixed-methods research and focuses on experiences, processes and critical moments associated with change over time. The research team will specifically implement LQR to understand processes by which the FOXY program contributed to changes in participants’ perception of HIV, sexual health, empowerment and/or cultural connectedness. For the post-intervention interview the team will use a semi-structured, open-ended interview guide. For the subsequent follow-up interview, participants will be provided a summary of the prior interview and will be asked to reflect on the summary and explore changes since the last interview.

This research study includes the participation of youth 13 to 15 years of age. Parental/guardian consent will be sought from participants. Consent to participate in research will follow the same process and protocols already in practice through FOXY who requires parental/guardian reverse consent and assent for youth in order for youth participate in programs and workshops. An assent form will be used for youth and a reverse consent form will be used with parents. A letter is sent to parents/guardians seven days prior to workshops and parents are informed that their children can “opt-out” of participation by returning a signed form or by calling the school. In addition, at FOXY, the research team are working with peer research assistants and research staff who have extensive experience working with adolescents and are well versed in anonymity, confidentiality, and explaining consent processes and protocols clearly and in non-academic language.

Research results will be disseminated through community forums to share select body-maps and critically discuss study findings; art gallery; interactive website withproject findings and a digital art gallery; project reports for arts-based prevention strategies for Northern Indigenous Youth; and, national/international conference presentations and peer reviewed journal article submissions.

The fieldwork for this study will be conducted from January 27, 2017 to December 31, 2017.