title: Arts-based HIV and STI prevention intervention with Northern and Indigenous youth in the Northwest Territories: study protocol for a non-randomised cohort pilot study.
abstract: Indigenous youth are disproportionately represented in new HIV infection rates in Canada. Current and historical contexts of colonisation and racism, disconnection from culture and land, as well as intergenerational trauma resulting from the legacy of residential schools are social drivers that elevate exposure to HIV among Indigenous peoples. Peer-education and arts-based interventions are increasingly used for HIV prevention with youth. Yet limited studies have evaluated longitudinal effects of arts-based approaches to HIV prevention with youth. The authors present a rationale and study protocol for an arts-based HIV prevention intervention with Northern and Indigenous youth in the Northwest Territories (NWT), Canada.
  
  
  
  This is a multicentre non-randomised cohort pilot study using a pretest/post-test design with a 12-month follow-up. The target population is Northern and Indigenous youth in 18 communities in the NWT. The aim is to recruit 150 youth using venue-based sampling at secondary schools. Participants will be involved in an arts-based intervention, Fostering Open eXpression among Youth (FOXY). Participants will complete a pretest, post-test survey directly following the intervention, and a 12-month follow-up. The primary outcome is new or enhanced HIV knowledge, and secondary outcomes to include: new or enhanced sexually transmitted infections knowledge, and increased self-esteem, resilience, empowerment, safer sex self-efficacy and cultural connectedness. Mixed effects regression analyses will be conducted to evaluate pretest and post-test differences in outcome measurement scores.
  
  
  
  This study has received approval from the HIV Research Ethics Board at the University of Toronto (REB: 31602). In addition, the project is currently registered in the NWT with the Aurora Research Institute (Licence: 15741). Trial results will be published according to the Transparent Reporting of Evaluations with Nonrandomised Designs statement.
  
  
  
  NCT02743026; Pre-results.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Fostering Open eXpression among Youth (FOXY), Yellowknife, Northwest Territories, Canada.
authors.forename: Candice
authors.initials: C
authors.lastname: Lys
authors.affiliation: Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
authors.forename: Carmen H
authors.initials: CH
authors.lastname: Logie
authors.affiliation: Fostering Open eXpression among Youth (FOXY), Yellowknife, Northwest Territories, Canada.
authors.forename: Nancy
authors.initials: N
authors.lastname: MacNeill
authors.affiliation: School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Loppie
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Lisa V
authors.initials: LV
authors.lastname: Dias
authors.affiliation: Canadian Aboriginal AIDS Network (CAAN), Vancouver, British Columbia, Canada.
authors.forename: Renée
authors.initials: R
authors.lastname: Masching
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Dionne
authors.initials: D
authors.lastname: Gesink
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D001154:Art; D015331:Cohort Studies; D003469:Culture; D004324:Drama; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D015658:HIV Infections / Q000517:prevention & control; D007198:Indians, North American; D033262:Narration; D015873:Northwest Territories; D010865:Pilot Projects; D011209:Power, Psychological; D012107:Research Design; D055500:Resilience, Psychological; D012381:Role Playing; D021841:Safe Sex; D012574:Schools; D020377:Self Efficacy; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D011795:Surveys and Questionnaires; D015337:Multicenter Studies as Topic; D002986:Clinical Trials as Topic
keywords: Northern; PREVENTIVE MEDICINE; indigenous; youth