title: Developing a culturally competent and socially relevant sexual health survey with an urban Arctic community.
abstract: OBJECTIVE
  To develop a culturally competent and socially relevant sexual health survey for people living in Nuuk, Greenland, aged 15 years and older.
  
  
  METHODS
  Qualitative study with interviews.
  
  
  METHODS
  Community and research informants (n=10) were interviewed informally to identify survey topics. A sexual health survey was constructed combining local knowledge from informants with a review of sexual health literature for the Arctic and other Indigenous locations. The draft survey was distributed to community partners for commentary and revision. After translation into Danish and Greenlandic, cognitive interviews were conducted with 11 Nuuk residents, identified through snowball sampling, to both pilot test the survey and exchange social and cultural knowledge relevant to sexual health in Nuuk. The utility of this process was evaluated against implementation of the final survey to Nuuk residents enrolled in Inuulluataarneq (n=149).
  
  
  RESULTS
  Theme saturation was reached by the ninth interview. STI risk and self-efficacy, co-occurrence of alcohol use and sex and STI knowledge were identified as most relevant. Questions about community efficacy, culture/community involvement and identity were most sensitive. Upon implementation of the final survey, 146 of 149 participants answered all survey questions. Two Elder participants refused to answer questions about sex. Some questions had low response variability but still added to our contextual understanding and helped to build rapport with participants.
  
  
  CONCLUSIONS
  Combining an iterative process with community-based participatory research principles and cognitive interview techniques was an effective method for developing a sexual health survey with Nuuk residents.
authors.affiliation: University of Toronto, Dalla Lana School of Public Health, Toronto, ON M5T 3M7, Canada. dionne.gesink@gmail.com
authors.forename: Dionne
authors.initials: D
authors.lastname: Gesink
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rink
authors.forename: Ruth
authors.initials: R
authors.lastname: Montgomery-Andersen
authors.forename: Gert
authors.initials: G
authors.lastname: Mulvad
authors.forename: Anders
authors.initials: A
authors.lastname: Koch
mesh_terms: D000293:Adolescent; D000328:Adult; D003469:Culture; D005260:Female; D006116:Greenland; D006306:Health Surveys; D006801:Humans; D004930:Inuit; D008297:Male; D008875:Middle Aged; D021841:Safe Sex / Q000208:ethnology*; D012725:Sexual Behavior / Q000208:ethnology*; D012749:Sexually Transmitted Diseases / Q000208:ethnology / Q000517:prevention & control / Q000523:psychology; D014505:Urban Population; D055815:Young Adult