"Native It’s Your Game" Focuses on Native Youth and Pregnancy Prevention

A Native American teen smiling.

An evidence-based sexual health and life skills program called “Native It’s Your Game” is helping Native American and Alaskan Indian youth learn how to make healthy decisions. The web-based prevention curriculum on pregnancy and sexually transmitted infections is based on another program, “It’s Your Game…Keep It Real Tech,” originally developed by The University of Texas Prevention Research Center as a classroom and computer-based educational program for middle school students.  

The original and adapted programs include 13 lessons covering issues such as healthy relationships, pregnancy, sexually transmitted infections, and risk reduction strategies. The lessons in the adapted version include culturally specific videos, interactive animations and fact sheets that appeal to Native youth.

[Read more about what impacts Native American middle schoolers’ decisions to have sex]

Moving to a Digital Alternative

A coalition of native state and local organizations, including the Northwest Portland Area Indian Health Board, the Alaska Native Tribal Health Consortium, and the Intertribal Council of Arizona, created “Native It’s your Game” to delay sexual initiation and prevent sexually transmitted infections among Native youth. Their goal was to provide a technology-based intervention program; however, coordinating 43 tribes with different resources and infrastructures presented a challenge.

The coalition surveyed teens and young adults in their communities about their technology use and how they get information. Youth reported higher Internet usage than expected and liked the idea of accessing these lessons privately.

Ultimately, the Northwest Portland Area Indian Health Board, the Alaska Native Tribal Health Consortium, and the Intertribal Council of Arizona, chose to adapt the “It’s Your Game…Keep It Real Tech” program because it was one of the few curricula designed for middle school students and didn’t require a lot of facilitation by an adult.

“It takes a unique person to be a great sexual health educator. If the community doesn’t have that person, we found the content wasn’t being delivered,” said Stephanie Craig Rushing, PhD, MPH, a project director at the Northwest Portland Area Indian Health Board. “We wanted to remove that barrier by having most of the education provided by the [online] platform.”

In a recent paper on the adaptation, the developers noted that there was a lack of sexual health curricula that focused on Native youth and technology-based interventions.

“The power of the Internet [allows youth to] go at their own pace. [There is the] potential for animation and video, and the potential for more discreet treatment of health topics,” said Ross Shegog, one of the developers of “Native It’s Your Game” from the University of Texas School of Public Health.

Focusing on Native Youth

The first video in the program begins with a parody of a traditional sexual health video. A dry voiceover drones on about the value of proper sexual education as a classroom of students, filmed in grainy black-and-white, patiently receives the lecture.

“Jeez, is this for real?” a youth in the video interrupts. “This is a little too old school, don’t you think?”

The video then transitions to more contemporary images of youth dancing in tribal wear and defining what “keeping it real” in the game of life means to them.

“We’re different from other people. We have our own traditions,” one of the youth shares. With the Native adaptation, the developers took a step outside of what’s normal in other youth-centered programs. Elders, who represent wisdom and guidance for Native youth, provided a synopsis and prologue for each lesson.

“It’s important to make an effort to bring in aspects of the target audiences’ belief system and culture that resonate,” Shegog said. “Whatever program you put out, you’re not trying to hammer a square peg into a round hole.”

[Read more about preventing teen pregnancy among Native youth]

Consider Adapting Your Own Program

For others considering adapting an existing program for their specific population, Rushing recognized that it’s time consuming and requires a lot of partners. Shegog seconded the need for partnership and suggested that developers and organizations work with the community.

“We did community-based research where we worked with the tribes, representatives, stakeholders, [and] end users to understand what would resonate,” he said. “It’s a foundational step to determine need and evaluate so you’re able to respond.”

Christina Markham, another developer of the “Native It’s Your Game” program, suggested that organizations start with a good model and work with the developer to maintain the core elements. Taking the program back to the end user for evaluation is also key, she said.

 “Native It’s Your Game” is currently being evaluated over a 12-month period, and data will be released soon. The program is currently available for free, on the Healthy Native Youth website.

Other adaptations of “It’s Your Game…Keep It Real” focus on dating violence and communication between parents and youth. A version is available for high school students, as is a version for HIV positive youth that focuses on skills training and adherence to medication schedules.

For more on sexual health resources for youth, visit The Exchange, a resource of FYSB’s Adolescent Pregnancy Prevention Program.

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