Alaska Alliance for Community Engagement Phase II: Partnership for Action Toward Health

Perceived Stress Scale Questionnaire will measure individual-level indicators of stress that we hypothesize will decrease over time with intervention participation

The NIH Toolbox Perceived Stress Scale is a standardized tool designed to assess how unpredictable, uncontrollable, and overloaded individuals feel in their lives. We will analyze how individual stress indicators are mitigated over time by intervention participation.

General Life Satisfaction Scale will measure individual level indicators of life satisfaction that we hypothesize will increase with intervention participation

The NIH Toolbox General Life Satisfaction Scale is a tool designed to assess an individual's cognitive evaluation of their life experiences and overall satisfaction. We will assess how the intervention mitigates life satisfaction with individuals who participate.

We will assess if depression decreases with intervention participation using the PHQ-9 Questionnaire

The Patient Health Questionnaire 9 (PHQ-9) measures the frequency of depressed mood and anhedonia over the past two weeks. We will assess how the intervention impacts depressive symptoms with individual participation.

We will assess if anxiety symptoms decrease with intervention participation using the GAD-7

The Generalized Anxiety Disorder 7-Item (GAD-7) Screener will be given at every time point to assess how the intervention mitigates anxiety with individual participants

We will assess the increase in community-level factors that are protective and contribute to health outcomes using the Protective Community Scale

The Protective Community Scale (PCS), developed by Wexler, Allen, and Rasmus, aims to identify community-level protective factors that can reduce suicide risk among Alaska Native youth. This scale is part of a broader effort to enhance resilience in these communities through culturally relevant measures and community engagement. We will analyze data from the PCS to determine if the intervention has mitigated environmental stressors and increased community protection.

We will assess changes to a stress biomarker, cortisol, using Salimetrics OnTimePoint SalivaTM Collection Management application system.

To measure the impacts of our intervention on biological outcomes, we will assess biomarkers associated with allostatic load - cortisol as an indicator of physiological stress response. These biomarkers will allow us to evaluate whether participation in the intervention is associated with reduced chronic stress burden and improved mental health (anxiety and depression) over time. Our proposed saliva collection protocol will involve our research team members administering the saliva kits with youth and adult participants over a 3-day period with multiple tests to capture cortisol levels throughout the day. Multi-day cortisol levels will be averaged to determine a baseline, and the same process will be used for saliva collection and measurement of cortisol levels at each time point.