{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T14:25:07Z","timestamp":1781360707042,"version":"3.54.1"},"reference-count":68,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T00:00:00Z","timestamp":1667174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>American Indian and Alaska Native (AI\/AN) youth experience serious disparities in sexual and reproductive health, including the highest teen birth rate among racial\/ethnic groups, and disproportionate rates of sexually transmitted infections (STI), including HIV. A growing number of evidence-based programs (EBPs) that integrate the strengths and cultural teachings of Native communities exist. Yet, multiple factors, including lack of trained personnel, limited resources, and geographic isolation, may hinder their adoption and implementation. Innovative implementation strategies that facilitate the adoption and implementation of sexual health EBPs in Native communities may help reduce these disparities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We applied Implementation Mapping, a systematic planning framework that utilizes theory, empirical evidence, and community input, to adapt a theory-based, online decision support system, iCHAMPSS (CHoosing And Maintaining Effective Programs for Sex Education in Schools), to support underlying dissemination and implementation processes unique to Native communities. We used an iterative design process, incorporating input from Native practitioners and academicians, to ensure that the adapted decision support system reflects cultural identification, community values, and experiences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Grounded in diffusion of innovations, organizational stage theory, and social cognitive theory, the <jats:italic>Healthy Native Youth Implementation Toolbox<\/jats:italic> supports Native practitioners through five phases (Gather, Choose, Prepare, Implement, and Grow) to adopt, implement, and maintain a culturally-relevant, age-appropriate sexual health EBP. The <jats:italic>Toolbox<\/jats:italic> provides tools, ready-to-use templates, and guidance to plan, implement, and grow a culturally-relevant adolescent health program with their Tribe or community. Hosted within the Healthy Native Youth website (<jats:ext-link>www.healthynativeyouth.org<\/jats:ext-link>), the <jats:italic>Toolbox<\/jats:italic> comprises: (1) a curriculum portal with access to 15 culturally-relevant, age-appropriate evidence-based health promotion programs for AI\/AN youth; (2) a \u201cresource library\u201d comprising 20+ support tools, templates, and links to external resources, and (3) \u201cstories from the field\u201d comprising testimonials from experienced Native educators, who have implemented sexual health programs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a continued need to design, test, and evaluate D&amp;amp;I strategies that are relevant to Native communities. The <jats:italic>Healthy Native Youth Implementation Toolbox<\/jats:italic> contributes to the dissemination and implementation of evidence-based, culturally-relevant sexual health education programs in diverse Native communities. Implementation Mapping provided a systematic approach to guide the adaptation process and integrate community voice with the ultimate goal of enhancing sexual health equity among AI\/AN youth.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.889924","type":"journal-article","created":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T04:56:55Z","timestamp":1667192215000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["The Healthy Native Youth Implementation Toolbox: Using Implementation Mapping to adapt an online decision support system to promote culturally-relevant sexual health education for American Indian and Alaska Native youth"],"prefix":"10.3389","volume":"10","author":[{"given":"Christine M.","family":"Markham","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie Craig","family":"Rushing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Manthei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Singer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Jessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwenda","family":"Gorman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa F.","family":"Peskin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Belinda F.","family":"Hernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Sacca","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabrielle S.","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Luna-Meza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Merritt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Shegog","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,31]]},"reference":[{"key":"B1","unstructured":"Profile: American Indian\/Alaska Native2022"},{"key":"B2","unstructured":"Facts for Features: American Indian and Alaska Native Heritage Month: November 20212022"},{"key":"B3","first-page":"1","article-title":"Births in the United States, 2017","volume":"318","author":"Martin","year":"2018","journal-title":"NCHS Data Brief."},{"key":"B4","first-page":"249","article-title":"Vital signs: repeat births among teens \u2014 United States, 2007\u20132010","volume":"62","author":"Gavin","year":"2013","journal-title":"Morb Mortal Wkly Rep."},{"key":"B5","unstructured":"HIV in the United States by Race\/Ethnicity: HIV Incidence"},{"key":"B6","year":"2018","journal-title":"Indian Health Surveillance Report - Sexually Transmitted Diseases 2015"},{"key":"B7","doi-asserted-by":"publisher","first-page":"S18","DOI":"10.2105\/AJPH.2016.303335","article-title":"The promise of technology to advance rigorous evaluation of adolescent pregnancy prevention programs in American Indian and Alaska Native tribal communities","author":"Kaufman","year":"2016","journal-title":"Am J Public Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"130186","DOI":"10.5888\/pcd10.130186","article-title":"Seeking best practices: a conceptual framework for planning and improving evidence-based practices","volume":"10","author":"Spencer","year":"2013","journal-title":"Prev Chronic Dis."},{"key":"B9","first-page":"163","article-title":"Using technology to promote health and wellbeing among American Indian and Alaska Native teens and young adults","author":"Craig Rushing","year":"2016","journal-title":"Indigenous People and Mobile Technologies"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1874","DOI":"10.2105\/AJPH.2021.306447","article-title":"Prevention of sexually transmitted diseases and pregnancy prevention among Native American youths: a randomized controlled trial, 2016-2018","volume":"111","author":"Tingey","year":"2021","journal-title":"Am J Public Health."},{"key":"B11","first-page":"3","article-title":"Native It's Your Game: improving psychosocial protective factors for HIV\/STI and teen pregnancy prevention among youth in American Indian\/Alaska Native communities","volume":"8","author":"Shegog","year":"2017","journal-title":"J Appl Res Child."},{"key":"B12","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1007\/s11121-018-0920-7","article-title":"Sexual Health, STI and HIV risk, and risk perceptions among American Indian and Alaska Native emerging adults","volume":"20","author":"Hafner","year":"2019","journal-title":"Prev Sci."},{"key":"B13","doi-asserted-by":"publisher","first-page":"321","DOI":"10.3390\/adolescents1030024","article-title":"Effectiveness of Native STAND: a five-year study of a culturally relevant sexual health intervention","volume":"1","author":"Skye","year":"2021","journal-title":"Adolescents."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e106","DOI":"10.2105\/AJPH.2013.301822","article-title":"Effectiveness of circle of life, an HIV-preventive intervention for American Indian Middle School Youths: a group randomized trial in a Northern Plains Tribe","volume":"104","author":"Kaufman","year":"2014","journal-title":"Am J Public Health."},{"key":"B15","doi-asserted-by":"publisher","first-page":"225","DOI":"10.3389\/fpubh.2018.00225","article-title":"Healthy Native Youth: Improving access to effective, culturally-relevant sexual health curricula","volume":"6","author":"Craig Rushing","year":"2018","journal-title":"Front Public Health."},{"key":"B16","doi-asserted-by":"publisher","first-page":"S424","DOI":"10.2105\/AJPH.2015.302674","article-title":"The adaptation and implementation of a community-based participatory research curriculum to build tribal research capacity","volume":"105","author":"Jernigan","year":"2015","journal-title":"Am J Public Health."},{"key":"B17","first-page":"1","article-title":"Choosing and maintaining programs for sex education in schools: the CHAMPSS model","volume":"2","author":"Hernandez","year":"2011","journal-title":"J Appl Res Child"},{"key":"B18","first-page":"1","article-title":"Sexual health education from the perspective of school staff: implications for adoption and implementation of effective programs in middle school","volume":"2","author":"Peskin","year":"2011","journal-title":"J Appl Res Child"},{"key":"B19","doi-asserted-by":"publisher","first-page":"203","DOI":"10.3389\/fpubh.2017.00203","article-title":"Using Intervention Mapping for program design and production of iCHAMPSS: an online-decision support system to increase adoption, implementation, and maintenance of evidence-based sexual health programs","volume":"5","author":"Peskin","year":"2017","journal-title":"Front Public Health."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1016\/j.dss.2005.07.002","article-title":"Progress in web-based decision support technologies","volume":"43","author":"Bhargava","year":"2007","journal-title":"Decis Support Syst"},{"key":"B21","volume-title":"Diffusion of Innovations","author":"Rogers","year":"2003"},{"key":"B22","first-page":"335","article-title":"Mobilizing organizations for health promotion: theories of organizational change","volume-title":"Health Behavior and Health Education: Theory, Research and Practice","author":"Butterfoss","year":"2008"},{"key":"B23","volume-title":"Social Foundations of Thought and Action","author":"Bandura","year":"1986"},{"key":"B24","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1177\/1524839916682004","article-title":"iCHAMPSS: Usability and psychosocial impact for increasing implementation of sexual health education","volume":"18","author":"Hernandez","year":"2017","journal-title":"Health Promo Pract."},{"key":"B25","first-page":"7","article-title":"Usability and psychosocial impact of decision support to increase sexual health education in American Indian and Alaska Native communities","volume":"11","author":"Markham","year":"2018","journal-title":"J Health Dispar Res Pract"},{"key":"B26","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s10488-013-0530-4","article-title":"American Indian perspectives on evidence-based practice implementation: results from a statewide tribal mental health gathering","volume":"42","author":"Walker","year":"2015","journal-title":"Adm Policy Ment Health."},{"key":"B27","doi-asserted-by":"publisher","first-page":"158","DOI":"10.3389\/fpubh.2019.00158","article-title":"Implementation Mapping: using intervention mapping to develop implementation strategies","volume":"7","author":"Fernandez","year":"2019","journal-title":"Front Public Health."},{"key":"B28","volume-title":"Planning Health Promotion Programs: An Intervention Mapping Approach","author":"Bartholomew Eldredge","year":"2016"},{"key":"B29","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1007\/s10464-008-9174-z","article-title":"Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation","volume":"41","author":"Wandersman","year":"2008","journal-title":"Am J Community Psychol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1007\/s10464-012-9525-7","article-title":"comparison of the interactive systems framework (ISF) for dissemination and implementation and the CDC division of HIV\/AIDS prevention's research-to-practice model for behavioral interventions","volume":"50","author":"Collins","year":"2012","journal-title":"Am J Community Psychol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"S40","DOI":"10.1097\/QAI.0b013e3181605df1","article-title":"The ADAPT-ITT model: a novel method of adapting evidence-based HIV interventions","volume":"47","author":"Wingood","year":"2008","journal-title":"J AIDS."},{"key":"B32","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1007\/s11121-008-0092-y","article-title":"Testing communities that care: the rationale, design and behavioral baseline equivalence of the community youth development study","volume":"9","author":"Hawkins","year":"2008","journal-title":"Prev Sci."},{"key":"B33","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1521\/aeap.2006.18.supp.59","article-title":"Adapting evidence\u2013based behavioral interventions for new settings and target populations","volume":"18","author":"McKleroy","year":"2006","journal-title":"AIDS Educ Prev"},{"key":"B34","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/S0149-7189(00)00028-8","article-title":"Getting to outcomes: a results-based approach to accountability","volume":"23","author":"Wandersman","year":"2000","journal-title":"Eval Program Plann."},{"key":"B35","unstructured":"Model Practice Database"},{"key":"B36","doi-asserted-by":"publisher","first-page":"834473","DOI":"10.3389\/fpubh.2022.834473","article-title":"Use of implementation mapping with community-based participatory research: development of implementation strategies of a new goal setting and goal management intervention system","volume":"10","author":"Kang","year":"2022","journal-title":"Front Public Health"},{"key":"B37","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1002\/j.2161-1912.2012.00008.x","article-title":"Cultural adaptation for therapy with American Indians and Alaska Natives","volume":"40","author":"Gray","year":"2012","journal-title":"J Multicult Couns Devel."},{"key":"B38","doi-asserted-by":"publisher","first-page":"596","DOI":"10.2105\/AJPH.2004.053801","article-title":"Building true capacity: indigenous models for indigenous communities","volume":"96","author":"Chino","year":"2006","journal-title":"Am J Public Health."},{"key":"B39","unstructured":"Implementation research: what it is and how to do itbmj\n            PetersDH\n            AdamT\n            AlongeO\n            AgyepongIA\n            TranN\n          Br Med J3472013"},{"key":"B40","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1007\/s10935-016-0440-9","article-title":"NATIVE-It's Your Game: adapting a technology-based sexual health curriculum for American Indian and Alaska Native youth","volume":"38","author":"Shegog","year":"2016","journal-title":"J Prim Prev."},{"key":"B41","doi-asserted-by":"publisher","first-page":"9126","DOI":"10.3390\/ijerph18179126","article-title":"Assessment of the reach, usability, and perceived impact of \u201cTalking is Power\u201d: a parental sexual health text-messaging service and web-based resource to empower sensitive conversations with American Indian and Alaska Native teens","volume":"18","author":"Sacca","year":"2021","journal-title":"Int J Environ Res Public Health."},{"key":"B42","doi-asserted-by":"publisher","first-page":"S71","DOI":"10.1089\/acm.2020.0393","article-title":"Feasibility of implementation mapping for integrative medical group visits","volume":"27","author":"Roth","year":"2021","journal-title":"J Altern Complement Med."},{"key":"B43","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1177\/1524839920957979","article-title":"Using implementation mapping to develop implementation strategies for the delivery of a cancer prevention and control phone navigation program: a collaboration with 2-1-1","volume":"23","author":"Ibekwe","year":"2022","journal-title":"Health Promot Pract."},{"key":"B44","unstructured":"Dissemination and Implementation Research in Health2016"},{"key":"B45","doi-asserted-by":"publisher","first-page":"437","DOI":"10.4278\/ajhp.22.6.437","article-title":"The ecological approach in health promotion programs: a decade later","volume":"22","author":"Kok","year":"2008","journal-title":"Am J Health Promot."},{"key":"B46","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1007\/s11121-019-01017-1","article-title":"Adapting a compilation of implementation strategies to advance school-based implementation research and practice","volume":"20","author":"Cook","year":"2019","journal-title":"Prev Sci."},{"key":"B47","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1016\/j.jsp.2019.07.014","article-title":"Importance and feasibility of an adapted set of implementation strategies in schools","volume":"76","author":"Lyon","year":"2019","journal-title":"J Sch Psychol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s13012-022-01190-y","article-title":"Barriers, frameworks, and mitigating strategies influencing the dissemination and implementation of health promotion interventions in Indigenous communities: a scoping review","volume":"17","author":"Sacca","year":"2022","journal-title":"Implement Sci."},{"key":"B49","first-page":"97","article-title":"Understanding barriers and facilitators for implementation across settings","volume-title":"Practical Implementation Science","author":"Fernandez","year":"2023"},{"key":"B50","unstructured":"Adolescent Health Tribal Action Plan"},{"key":"B51","unstructured":"Adolescent Health Tribal Action Plan"},{"key":"B52","volume-title":"Predicting and Changing Behaviour: The Reasoned Action Approach","author":"Fishbein","year":"2010"},{"key":"B53","volume-title":"Communication and Persuasion: Central and Peripheral Routes to Attitude Change","author":"Petty","year":"2012"},{"key":"B54","volume-title":"Organization Development and Change","author":"Cummings","year":"2014"},{"key":"B55","first-page":"303","article-title":"Natural helper models to enhance a community's health and competence","volume-title":"Emerging Theories in Health Promotion Practice and Research","author":"Eng","year":"2009"},{"key":"B56","unstructured":"TrevinoN\n            GastonA\n          Portland, ORNorthwest Portland Area Indian Health BoardHealthy Native Youth: Virtual Adaptation Guide"},{"key":"B57","first-page":"183","article-title":"Social support and health behavior","volume-title":"Health Behavior: Theory, Research and Practice","author":"Holt-Lunstad","year":"2015"},{"key":"B58","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1111\/j.1746-1561.2011.00617.x","article-title":"Cultural tailoring and feasibility assessment of a sexual health middle school curriculum: a pilot test in Puerto Rico","volume":"81","author":"Escobar-Chaves","year":"2011","journal-title":"J Sch Health."},{"key":"B59","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1080\/09540120802385637","article-title":"+CLICK: Harnessing web-based training to reduce secondary transmission among HIV-positive youth","volume":"21","author":"Markham","year":"2009","journal-title":"AIDS Care"},{"key":"B60","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1007\/s11414-015-9475-6","article-title":"Methods to improve the selection and tailoring of implementation strategies","volume":"44","author":"Powell","year":"2017","journal-title":"J Behav Health Serv Res"},{"key":"B61","doi-asserted-by":"publisher","first-page":"136","DOI":"10.3389\/fpubh.2018.00136","article-title":"From classification to causality: advancing understanding of mechanisms of change in implementation science","volume":"6","author":"Lewis","year":"2018","journal-title":"Front Public Health."},{"key":"B62","doi-asserted-by":"publisher","first-page":"101620","DOI":"10.1016\/j.pmedr.2021.101620","article-title":"Application of community\u2013engaged dissemination and implementation science to improve health equity","volume":"24","author":"Schlechter","year":"2021","journal-title":"Prev Med Rep."},{"key":"B63","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/2633489520985305","article-title":"Community engagement in dissemination and implementation models: a narrative review","volume":"1","author":"Pinto","year":"2021","journal-title":"Implement Res Pract."},{"key":"B64","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1023\/A:1019902902119","article-title":"Cultural sensitivity and adaptation in family-based prevention interventions","volume":"3","author":"Kumpfer","year":"2002","journal-title":"Prev Sci."},{"key":"B65","first-page":"10","article-title":"Cultural sensitivity in public health: defined and demystified","volume":"9","author":"Resnicow","year":"1999","journal-title":"Ethn Dis."},{"key":"B66","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1177\/1090198102251021","article-title":"Achieving cultural appropriateness in health promotion programs: targeted and tailored approaches","volume":"30","author":"Kreuter","year":"2003","journal-title":"Health Educ Behav."},{"key":"B67","first-page":"331","volume-title":"Family Psychology: Science-Based Interventions","author":"Santisteban","year":"2001"},{"key":"B68","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1023\/A:1007091405097","article-title":"Cultural consideration is family-based primary prevention programs in drug abuse","volume":"21","author":"Turner","year":"2000","journal-title":"J Prim Prev."}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.889924\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,31]],"date-time":"2022-10-31T04:57:17Z","timestamp":1667192237000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2022.889924\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,31]]},"references-count":68,"alternative-id":["10.3389\/fpubh.2022.889924"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2022.889924","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,31]]},"article-number":"889924"}}