Table 1 EMPWR Program Evaluation Measures

EMPWR Questionnaire

Assesses sexual behavior and related risk factors through close-ended questions that asks about STD and sexual behavior history, knowledge and attitudes. Adapted from that which was implemented in the original trial of RESPECT [33].

Historical Loss Scale

12-item assessment that asks questions about losses that may be experienced by AI adults and rate how frequently the loss comes to mind [46].

Care Seeking Scale

4-item scale developed by the research team to assess health-seeking behaviors and preferences for medical care.

Enculturation and Discrimination Scale

27-item scale assessing the extent to which a person is embedded in their culture, self-reported cultural identify and perceived discrimination [47].

Spiritual Coping Scale

1-item that asks the extent to which a participant’s spirituality is involved in their understanding of or dealing with stressful situations.

Suicide and Self-Injury Risk Assessment

Adapted from two suicide assessments, the Columbia Suicide Screen [48] and the Suicide Intent Scale [49], it consists of 17-items evaluating past suicidal and self-injurious behavior.

Brief Symptom Inventory

53-item psychological self-report symptom scale that measures a person’s overall psychological distress level and the number and intensity of symptoms [50].