American Indian and Alaska Native (AI/AN) youth are disproportionally burdened by high rates of sexually transmitted infections and teen pregnancy, heightening their need for sexual health interventions that are aligned to their unique culture and social context. Media technologies, including the Internet, cell phones, and video games, offer new avenues for reaching adolescents on a range of sensitive health topics. While several studies have informed the development of technology-based interventions targeting mainstream youth, no such data have been reported for AI/AN youth. To fill this gap, I: (a) quantified media technology use in a select group of AI/AN teens and young adults living in Pacific Northwest tribes and urban communities; (b) identified patterns in their health information-seeking and media preferences; and (c) worked with local tribes and regional partners to develop recommendations for designing culturally-appropriate technology-based interventions targeting Native adolescents.

This research included: (a) an anonymous, paper-based survey of over 400 AI/AN youths age 13-21 years; (b) a systematic review of technology-based sexual health interventions; and (c) a variety of community-based participatory research activities to analyze findings, prioritize options, and generate recommendations for designing interventions that align with the culture, needs, and organizational capacities of the tribes in the Pacific Northwest.

Technology use was exceptionally common and diverse among survey respondents, mirroring patterns reported by teens in the general population. Seventy-five percent of AI/AN youth reported using the Internet, 78% reported using cell phones, and 36% reported playing video games on a daily or weekly basis. Thirty-five percent reported that they would feel most comfortable getting sexual health information from the Internet, and 44% reported having done so in the past. Youth expressed interest in a wide array of interactive media features, and culturally-specific content that holistically encompassed their wide-ranging health interests and concerns. Tribal health educators expressed particular interest in adapting Internet-based skill-building modules and informational websites, and teens expressed interest in websites and videos. These findings are now being used by the Northwest Portland Area Indian Health Board to inform the development and adaptation of culturally-appropriate interventions targeting AI/AN youth in the Pacific Northwest.