Date of Conferral

10-3-2025

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Patrick Dunn

Abstract

Alaska Native youth experience disproportionately high rates of sexual risk, yet disaggregated data and school-contextual analyses remain limited. Understanding how school type (alternative vs. traditional) and individual factors influence sexual risk among Alaska Native youth is essential for informing targeted, culturally responsive health interventions and addressing ongoing health disparities. This quantitative study aimed to examine the association between three behaviors (condom use, multiple sexual partners, and substance use) by school type, controlling for gender, grade level, body mass index, and afterschool activity. Guided by the social-ecological model, this cross-sectional study provided new insights into the relationship between school type and sexual risk behaviors among 9th – 12th grade students in Alaska’s Lower Kuskokwim region. Secondary data, with a sample size of 458 students, were obtained from the Alaska Department of Health, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion, Alaska Youth Risk Behavior Survey. Descriptive statistics, complex samples crosstabulations, and multiple binary logistic regressions were used to identify significant associations between variables, while controlling for other factors. Results showed that school type was not significantly associated with condom or substance use; however, students in the traditional school had significantly higher odds of having multiple partners (OR = 3.76, p = .001), challenging common assumptions about alternative school settings. Field-based products developed in response to this study may be used to raise awareness of Alaska Native-specific health risks related to school type, to encourage further studies, inform health legislation, and expand resources for Alaska Native youth.

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