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Alessandra Angelino (she/her) is a 3rd-year pediatrics resident at UNC Children’s Hospital who earned her medical degree at Rutgers Robert Wood Johnson Medical School and her MPH in Global Health at the University of Washington. She is passionate about Two-Spirit and LGBTQ health and advocacy and has authored multiple publications and the “Celebrating Our Magic” toolkit on this topic. She has worked in Indigenous clinical settings in Washington, North Carolina, and Australia and continues to work closely with the Indian Health Service and Northwest Portland Area Indian Health Board on projects related to Two-Spirit and LGBTQ health. She serves on the Committee on Native American Child Health through the American Academy of Pediatrics.


American Indian and Alaska Native (AI/AN) youth and adolescents face significant physical and mental health disparities. These inequities result from historical and intergenerational trauma; the cumulative, permeating effects of traumas that impact individuals and communities who share a specific identity. This project assesses the relationship between cultural identity and outcomes associated with mental health (loneliness, friendships, emotional support, and sleep) for AI/AN adolescents. It also aims to understand the impact of the COVID-19 pandemic on stress management for AI/AN adolescents.

This mixed-methods study involves two phases informed by the principles of community-based participatory research. Phase 1, discussed in this abstract, involved distribution of surveys using validated instruments to assess cultural connection, mental health outcomes, stress management, and resilience among participants. Phase 2 involves semi-structured interviews with adolescents. 12-18-year-old adolescents from a large AI/AN tribe in the Southeastern United States were enrolled in this study.

Results indicate that there were moderate positive correlations between ethnic identity and mental health (correlation: 0.24, 95%CI (0.07, 0.4)), measured by friendship (correlation: 0.24, 95% CI (0.06,0.4)) and emotional support (correlation: 0.26, 95% CI (0.009, 0.42). This work can help inform future work that aims to increase culture and community connection and build upon already existing resilience. It also emphasizes the importance of community-based research and community-driven solutions. Data related to cultural connection and mental health outcomes can be used to set the framework for policy formulation which may allow for increased funding and programming addressing mental health for AI/AN youth and adolescents.