{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T18:23:50Z","timestamp":1784744630230,"version":"3.55.0"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T00:00:00Z","timestamp":1676419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical Research Council","award":["MR\/R022739\/1"],"award-info":[{"award-number":["MR\/R022739\/1"]}]},{"name":"FUNDECT\/CONFAP","award":["SIAFEM 028920"],"award-info":[{"award-number":["SIAFEM 028920"]}]},{"name":"Academy of Medical Science","award":["NIFR7\\1004"],"award-info":[{"award-number":["NIFR7\\1004"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Latin America and the Caribbean Region are home to about 42 million Indigenous people, with about 900,000 living in Brazil. The little routinely collected population-level data from Indigenous communities in the region available shows stark inequities in health and well-being. There are 305 Indigenous ethnic groups, speaking 274 languages, spread across the remote national territory, who have endured long-lasting inequities related to poverty, poor health, and limited access to health care. Malnutrition and mental health are key concerns for young people. Building on our Indigenous communities-academic partnerships over the last two decades, we collaborated with young people from the Terena Indigenous ethnic group, village leaders, teachers, parents, and local health practitioners from the Polo Base (community health centres) to obtain their perspectives on important and feasible actions for a youth health promotion programme.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The report was conducted in the Terer\u00e9 Village in Mato Grosso do Sul. Concept mapping, a participatory mixed method approach, was conducted in 7 workshops, 15 adults and 40 youths aged 9\u201317 years. Art-based concept mapping was used with 9 to 11 years old children (N = 20). Concept systems software was used to create concept maps, which were finalised during the workshops. Focused prompts related to factors that may influence the health and happiness of youths. The participatory method gave Terena youths a significant voice in shaping an agenda that can improve their health.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Terena youths identified priority actions that clustered under \u2018Family\u2019, \u2018School\u2019, \u2018Education\u2019, \u2018Socio-economic circumstances\u2019, \u2018Respect\u2019 and \u2018Sport\u2019 in response to protecting happiness; and \u2018Nutrition pattern\u2019, \u2018Physical activity\u2019, \u2018Local environment\u2019, and \u2018Well-being\u2019 in response to having a healthy body. Through the participatory lens of concept mapping, youths articulated the interconnectedness of priority actions across these clusters such that behaviours (e.g. Nutrition pattern, drinking water, physical activity) and aspirations (being able to read, to have a good job) were recognised to be dependent on a wider ecology of factors (e.g. loss of eco-systems, parent-child relationships, student- teacher relationships, parental unemployment). In response to developing youth health, Terena adults suggested priority actions that clustered under \u2018Relationships\u2019, \u2018Health issues\u2019, \u2018Prevention at Polo Base\u2019, \u2018Access to health care\u2019, \u2018Communication with young people\u2019, \u2018Community life\u2019, \u2018Raising awareness\u2019 and \u2018School support\u2019. Their priorities reflected the need for structural transformative actions (e.g. Polo Base and school staff working together) and for embedding actions to protect Indigenous culture (e.g. integrating their cultural knowledge into training programmes).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Concept maps of Indigenous youths emphasised the need for a health promotion programme that engages with the structural and social determinants of health to protect their happiness and health, whilst those of adults emphasised the need to address specific health issues through preventative care via a school-Polo Base collaboration. Investment in a co-developed school-Polo-Base health promotion programme, with intersectoral engagement, has potential for making Indigenous health systems responsive to the inequalities of youth health, to yield dividends for healthy ageing trajectories as well as for the health of the next generation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0269653","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T18:29:41Z","timestamp":1676485781000},"page":"e0269653","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":12,"title":["Co-developing a health promotion programme for indigenous youths in Brazil: A concept mapping report"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0416-534X","authenticated-orcid":true,"given":"Paulo T.","family":"C. Jardim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josiliane M.","family":"Dias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7182-075X","authenticated-orcid":true,"given":"Antonio J.","family":"Grande","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9 B.","family":"Veras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9rika K.","family":"Ferri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3365-6001","authenticated-orcid":true,"given":"Fatima A. A.","family":"Quadros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clayton","family":"Peixoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francielle C. S.","family":"Botelho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"I. M. G. Oliveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9445-6062","authenticated-orcid":true,"given":"Ieda M. A. V.","family":"Dias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0204-3835","authenticated-orcid":true,"given":"Majella","family":"O\u2019Keeffe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8298-8440","authenticated-orcid":true,"given":"Christelle","family":"Elia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Dazzan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Wolfe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seeromanie","family":"Harding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,2,15]]},"reference":[{"key":"pone.0269653.ref001","article-title":"Indigenous Latin America in the twenty-first century: the first decade.","author":"GN Freire","year":"2015","journal-title":"The World Bank;"},{"key":"pone.0269653.ref002","first-page":"e00085516","article-title":"Sociodemographic characteristics of Indigenous population according to the 2000 and 2010 Brazilian demographic censuses: a comparative approach.","volume":"331","author":"JL Bastos","year":"2017","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"pone.0269653.ref003","volume-title":"Caracter\u00edsticas \u00c9tnico-raciais da Popula\u00e7\u00e3o: um estudo das categorias de classifica\u00e7\u00e3o de cor ou ra\u00e7a 2008","author":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE)","year":"2011"},{"issue":"7","key":"pone.0269653.ref004","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1590\/1806-9282.66.7.861","article-title":"COVID-19 experience among Brasil\u2019s indigenous people.","volume":"66","author":"PD Jardim","year":"2020","journal-title":"Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira."},{"key":"pone.0269653.ref005","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1590\/S0102-311X2011001200005","article-title":"Aspectos demogr\u00e1ficos e mortalidade de popula\u00e7\u00f5es ind\u00edgenas do Estado do Mato Grosso do Sul, Brasil.","volume":"27","author":"ME Ferreira","year":"2011","journal-title":"Cadernos de Sa\u00fade P\u00fablica"},{"issue":"1","key":"pone.0269653.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1471-2458-13-52","article-title":"The First National Survey of Indigenous People\u2019s Health and Nutrition in Brazil: rationale, methodology, and overview of results.","volume":"13","author":"CE Coimbra","year":"2013","journal-title":"BMC Public Health"},{"key":"pone.0269653.ref007","volume-title":"Censo demogr\u00e1fico 2010: caracter\u00edsticas gerais dos ind\u00edgenas\u2013resultados do universo","author":"Instituto Brasileiro de Geografia e Estat\u00edstica (IBGE)","year":"2012"},{"key":"pone.0269653.ref008","volume-title":"Strategies of Suicide prevention among indigenous peoples.","author":"Brasil","year":"2019"},{"issue":"23","key":"pone.0269653.ref009","first-page":"e200004","article-title":"Viol\u00eancias contra adolescentes: an\u00e1lise das notifica\u00e7\u00f5es realizadas no setor sa\u00fade, Brasil, 2011\u20132017.","volume":"3","author":"VO Pereira","year":"2020","journal-title":"Revista Brasileira de Epidemiologia."},{"key":"pone.0269653.ref010","article-title":"Terena-Povos ind\u00edgenas no Brasil.","author":"Povo Terena Brasil","year":"2021","journal-title":"Brasil"},{"issue":"1","key":"pone.0269653.ref011","first-page":"57","article-title":"Infant mortality among Indigenous and non-Indigenous people in the Brazilian microregions.","volume":"72","author":"GL Marinho","year":"2019","journal-title":"Revista brasileira de enfermagem."},{"key":"pone.0269653.ref012","doi-asserted-by":"crossref","first-page":"e00023915","DOI":"10.1590\/0102-311X00023915","article-title":"Preval\u00eancia de diabetes mellitus e fatores associados em mulheres ind\u00edgenas do Munic\u00edpio de Dourados, Mato Grosso do Sul, Brasil.","volume":"32","author":"GA Freitas","year":"2016","journal-title":"Cadernos de Sa\u00fade P\u00fablica."},{"key":"pone.0269653.ref013","article-title":"Os povos ind\u00edgenas na sala de aula: Um estudo a partir de representa\u00e7\u00f5es de estudantes do 1\u00b0 ano do ensino fundamental de uma escola de campo grande\/ms.","author":"Costa EKBd","year":"2017"},{"key":"pone.0269653.ref014","article-title":"Secretaria de Estado de Cidadania e Cultura","year":"2021","journal-title":"Comunidades ind\u00edgenas"},{"key":"pone.0269653.ref015","author":"Universidade Estadual de Mato Grosso do Sul","year":"2021","journal-title":"Aos 28 anos, UEMS consolida protagonismo junto ao povo de MS;"},{"key":"pone.0269653.ref016","volume-title":"Alliance for Health Policy and Systems Research","author":"WHO","year":"2009"},{"issue":"10","key":"pone.0269653.ref017","doi-asserted-by":"crossref","first-page":"1392","DOI":"10.1177\/1049732305278876","article-title":"An introduction to concept mapping as a participatory public health research method.","volume":"15","author":"O Burke JG","year":"2005","journal-title":"Qualitative health research."},{"key":"pone.0269653.ref018","article-title":"A concept mapping study of physicians\u2019 perceptions of factors influencing management and control of hypertension in sub-Saharan Africa","author":"J Iwelunmor","year":"2015","journal-title":"International journal of hypertension"},{"issue":"1","key":"pone.0269653.ref019","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1748-5908-6-104","article-title":"A comparison of policy and direct practice stakeholder perceptions of factors affecting evidence-based practice implementation using concept mapping","volume":"6","author":"AE Green","year":"2011","journal-title":"Implementation Science"},{"issue":"3","key":"pone.0269653.ref020","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/j.evalprogplan.2007.05.007","article-title":"Translating research into practice: Using concept mapping to determine locally relevant intervention strategies to increase physical activity.","volume":"30","author":"CM Kelly","year":"2007","journal-title":"Evaluation and program planning."},{"key":"pone.0269653.ref021","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.iheduc.2017.08.002","article-title":"Eliciting the challenges and opportunities organizations face when delivering open online education: A group-concept mapping study.","volume":"36","author":"M Schophuizen","year":"2018","journal-title":"The Internet and Higher Education"},{"issue":"2","key":"pone.0269653.ref022","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1080\/0950069032000097361","article-title":"The power and benefits of concept mapping: measuring use, usefulness, ease of use, and satisfaction","volume":"26","author":"LA Freeman","year":"2004","journal-title":"International Journal of Science Education"},{"issue":"1","key":"pone.0269653.ref023","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/0149-7189(89)90016-5","article-title":"An introduction to concept mapping for planning and evaluation.","volume":"12","author":"WM Trochim","year":"1989","journal-title":"Evaluation and program planning."},{"issue":"2","key":"pone.0269653.ref024","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1080\/00043125.2019.1695478","article-title":"Concept Mapping: A Practical Process for Understanding and Conducting Art Education Research and Practice.","volume":"73","author":"Y Cooper","year":"2020","journal-title":"Art Education."},{"issue":"3","key":"pone.0269653.ref025","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1093\/jpepsy\/jst079","article-title":"The use of Likert scales with children","volume":"39","author":"D Mellor","year":"2014","journal-title":"Journal of pediatric psychology"},{"key":"pone.0269653.ref026","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.evalprogplan.2016.10.006","article-title":"Introduction to a special issue on concept mapping.","volume":"60","author":"WM Trochim","year":"2017","journal-title":"Eval Program Plann."},{"key":"pone.0269653.ref027","article-title":"Health Plan for Indigenous Youth in Latin America and the Caribbean.","author":"PAHO\/WHO","year":"2017","journal-title":"Brasilia, Brazil"},{"key":"pone.0269653.ref028","volume-title":"A viol\u00eancia contra os povos ind\u00edgenas no Brasil. A viol\u00eancia contra os povos ind\u00edgenas no Brasil","author":"Catholic Church","year":"2020"},{"issue":"6","key":"pone.0269653.ref029","doi-asserted-by":"crossref","first-page":"844","DOI":"10.3102\/0034654318794134","article-title":"A review of research connecting digital storytelling, photovoice, and civic engagement","volume":"88","author":"S Greene","year":"2018","journal-title":"Review of Educational Research"},{"issue":"1","key":"pone.0269653.ref030","article-title":"Alcoholism and violence in indigenous ethnic groups: a critical review of the Brazilian situation, Psicol.","volume":"19","author":"M Guimar\u00e3es L A","year":"2007","journal-title":"Soc"},{"issue":"251","key":"pone.0269653.ref031","doi-asserted-by":"crossref","DOI":"10.24109\/2176-6681.rbep.99i252.3337","article-title":"Estudantes ind\u00edgenas em universidades brasileiras: um estudo das pol\u00edticas de acesso e perman\u00eancia.","volume":"99","author":"M Bergamaschi","year":"2018","journal-title":"Revista Brasileira de Estudos Pedag\u00f3gicos."},{"issue":"36","key":"pone.0269653.ref032","article-title":"Popula\u00e7\u00f5es tradicionais e inclus\u00e3o social no Brasil: Um paralelo entre as pol\u00edticas de acesso \u00e0 terra e \u00e0 educa\u00e7\u00e3o superior por ind\u00edgenas e quilombolas.","volume":"10","author":"A L\u00facia Aguiar Melo","year":"2018","journal-title":"Am\u00e9rique Latine Histoire et M\u00e9moire. Les Cahiers ALHIM. Les Cahiers ALHIM"},{"key":"pone.0269653.ref033","article-title":"The Amazon is reaching a dangerous tipping point. We need to scale solutions now if we have any chance of saving it","author":"P Barreto","year":"2019","journal-title":"World Economic Forum. Brasil"},{"issue":"3","key":"pone.0269653.ref034","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1177\/1177180118796870","article-title":"Arts-based research methods with indigenous peoples: An international scoping review.","volume":"14","author":"C Hammond","year":"2018","journal-title":"AlterNative: An International Journal of Indigenous Peoples"},{"key":"pone.0269653.ref035","volume-title":"State of the world\u2019s Indigenous peoples","author":"UN","year":"2009"},{"key":"pone.0269653.ref036","volume-title":"Pol\u00edtica Nacional de Aten\u00e7\u00e3o \u00e0 Sa\u00fade dos Povos Ind\u00edgenas.","author":"Brasil","year":"2002"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269653","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T18:30:23Z","timestamp":1676485823000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0269653"}},"subtitle":[],"editor":[{"given":"Akihiro","family":"Nishi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,2,15]]},"references-count":36,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,2,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0269653","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,15]]}}}