E E Haroz
Biographic Data
| ID | 1730446 |
|---|---|
| NAME | E E Haroz |
| GIVEN NAMES | E E |
| FAMILY NAME | Haroz |
| SIGNATURE | HAROZ E E |
| AFFILIATIONS | Johns Hopkins University |
| ORCID | 0000-0003-1833-4925 |
| VERIFIED | Yes |
| TOTAL WORKS | 40 |
| TOTAL CITATIONS | 26 |
| AUTHOR COUNT | 40 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2013 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Testing the effectiveness of Family Spirit Strengths (FSS) – a culturally informed intervention designed to prevent mental health and substance misuse for indigenous families through home visiting
Families represent the foundation of health for many Indigenous communities. Yet, Indigenous women, particularly women of the age who are starting families, face profound challenges related to mental health and substance use. These challenges are rooted in historical trauma, ongoing discrimination, systemic racism, and chronic underfunding of mental health and substance use services, and result in significant gaps in access to care. Family-based …
The adaptation process of a safety planning intervention to promote connectedness and reduce distress in Diné adolescents and adults during the Covid-19 pandemic
Introduction: (Navajo) language, arrived in the Southwest in March 2020. The virus quickly spread amongst Diné communities and contributed to immediate school closures. These closures created significant disruption to connectedness on the Navajo Nation. Methods: As part of the Community Based Participatory Research process, our team worked with a Community Advisory Board (CAB) to facilitate a longitudinal cohort study titled "Project SafeSchools"…
Self-harm and suicide prevention in humanitarian and fragile contexts
Suicide remains one of the leading causes of death globally, with growing evidence that humanitarian emergencies and fragile states, most of which unfold in low- to middle-income countries (LMICs), are associated with elevated risk of suicide. However, the few suicide-targeted interventions for use in humanitarian contexts remain both sparse and fragmented. This scoping review aims to identify and synthesise evidence from suicide and self-harm pr…
Pilot evaluation of a Psychological First Aid online training for Covid-19 frontline workers in American Indian/Alaska Native communities
Introduction: The COVID-19 pandemic exacerbated mental health concerns and stress among American Indians and Alaska Natives (AI/ANs) in the United States, as well as among frontline workers responding to the pandemic. Psychological First Aid (PFA) is a promising intervention to support mental wellbeing and coping skills during and after traumatic events, such as the COVID-19 pandemic. Since PFA is often implemented rapidly in the wake of a disast…
Honoring our teachings
Introduction American Indian and Alaska Native (AIAN) communities continue to flourish and innovate in the face of the COVID-19 pandemic. Storytelling is an important tradition for AIAN communities that can function as an intervention modality. To support the needs of AIAN children and caregivers, we (a collaborative workgroup of Indigenous health researchers) developed a culturally grounded storybook that provides pandemic-related public health …
Withdrawal
Withdrawal: ‘Baseline Sociodemographic Characteristics and Mental Health Status of Primary Caregivers and Children Attending Schools on the Navajo Nation and White Mountain Apache Tribe During COVID‐19’ by Shannon Archuleta MPH, Joshuaa D. Allison‐Burbank PhD, Allison Ingalls MPH, Renae Begay MPH, Ryan Grass BS, Francene Larzelere PhD, Vanessa Begaye BS, Lacey Howe BS, Alicia Tsosie BS, Angelina Phoebe Keryte BA, Emily E. Haroz PhD, J Sch Health …
Baseline Sociodemographic Characteristics and Mental Health Status of Primary Caregivers and Children Attending Schools on the Navajo Nation During Covid ‐19
BACKGROUND: Despite historical and contemporary trauma, American Indian and Alaska Native (AIAN; Indigenous) communities responded with resilience to the COVID-19 pandemic. However, AIANs experienced disproportionate rates of infection, hospitalization, death, and reduced life expectancy. School closures exacerbated disparities, leading to learning loss, economic instability, and mental health challenges among AIAN youth. METHODS: The Project Saf…
Barriers and Facilitators to Covid-19 Return to School
This study aimed to understand facilitators and barriers to returning to in-person learning for youth, caregivers, and school staff from three communities in the Navajo Nation and the White Mountain Apache Tribe following the 2020 COVID-19-driven school closures. A safe and rapid return to school through effective and acceptable COVID-19 mitigation strategies was vital for students’ social and scholastic development and the resilience of staff an…
Facilitators and Barriers to Implementing a Community Suicide Database and Prevention Program in Diverse Tribal Communities
Suicide is the second leading cause of death for American Indian youth, far surpassing the rates of suicide experienced by other races. The White Mountain Apache Tribe has made significant impacts on suicide risk by implementing a robust suicide prevention program which includes a community-led database and case management follow-ups. Due to the success of the program in preventing suicides, the White Mountain Apache team has worked with other tr…
Community-Engaged Development of Strengths-Based Nutrition Measures
Mainstream approaches to nutrition typically focus on diet consumption, overlooking multi-dimensional aspects of nutrition that are important to American Indian/Alaska Native (AI/AN) communities. To address health challenges faced by AI/AN communities, strengths-based measures of nutrition grounded in community worldviews are needed. In collaboration with AI/AN communities in Baltimore and Minneapolis, we developed the Indigenous Nourishment Scal…
A qualitative study of mental health problems among children living in New Delhi slums
Children living in urban slums in India are exposed to chronic stressors that increase their risk of developing mental disorders, but they remain a neglected group. Effective mental health interventions are needed; however, it is necessary to understand how mental health symptoms and needs are perceived and prioritized locally to tailor interventions for this population. We used an existing rapid ethnographic assessment approach to identify menta…
Understanding opioid use within a Southwestern American Indian Reservation Community
PURPOSE: Morbidity and mortality due to nonprescription use of opioids has been well documented following the significant increase in the availability of prescription opioids in the early 2000s. The aim of this paper is to explore community beliefs about correlates of opioid risk, protective factors, and behavioral functions of opioid misuse among American Indian youth and young adults living on or near a reservation. METHODS: Qualitative in-dept…
Respecting diverse journeys on many roads
Translation challenges persist among early childhood evidence-based home visiting programs. There is a need for a significant shift in the field to overcome the constraints of standardized home visiting interventions. A precision framework has been identified as a method to understand what is needed to address the unique needs of families. We argue that Indigenous experiences implementing home visiting programs overlap with precision home visitin…
Implementation measurement in global mental health
Limited guidance exists to support investigators in the choice, adaptation, validation and use of implementation measures for global mental health implementation research. Our objectives were to develop consensus on best practices for implementation measurement and identify strengths and opportunities in current practice. We convened seven expert panelists. Participants rated approaches to measure adaptation and validation according to appropriat…
Centering Indigenous Knowledges and Worldviews
Globally, Indigenous communities, leaders, mental health providers, and scholars have called for strengths-based approaches to mental health that align with Indigenous and holistic concepts of health and wellness. We applied the Indigenist Ecological Systems Model to strengths-based case examples of Indigenous youth mental health and wellness work occurring in CANZUS (Canada, Australia, New Zealand, and United States). The case examples include r…
Measuring the effects of the Covid-19 pandemic on Diné and White Mountain Apache school personnel, families, and students
The results of this study will inform the development or implementation of preventative interventions that may help Diné and Apache youth and their families recover from the negative impact of the COVID-19 pandemic, and positively impact their health and wellness
Home visitor perspectives on implementing a precision approach to home visiting in communities serving Native American families
Family Spirit (FS) is a federally endorsed evidence‐based home visiting programs serving as a key prevention strategy for expectant families and families with young children. Like other home‐visiting programs, it shares client challenges in retention and engagement during implementation. We assessed (1) the feasibility and acceptability of implementing a precision approach to FS; and (2) differences in approaches to FS delivery. Home visitors, se…
Nurturing Innovation at the Roots
Nurturing Innovation at the Roots: The Success of COVID-19 Vaccination in American Indian and Alaska Native Communities Emily E. HarozPhD, MA, MHS, Christopher G. KempPhD, MPH, Victoria M. O'KeefePhD, MS, Katherine PocockPA-C, David R. WilsonPhD, Loretta ChristensenMD, MBA, MSJ, FACS, Melissa WallsMA, PhD, Allison BarlowPhD, and Laura HammittMD Affiliation Emily E. Haroz, Christopher G. Kemp, Victoria M. O'Keefe, Melissa Walls, Allison Barlow, an…
A randomized-controlled trial of community-based transdiagnostic psychotherapy for veterans and internally displaced persons in Ukraine
Standard CETA is more effective than brief CETA, but brief CETA also had significant effects compared with wait-controls. Given demonstrated effectiveness, CETA could be scaled up as an effective community-based approach
Planning for suicide prevention in Thai refugee camps
Suicide and associated behaviors represent a significant health disparity among refugees and displaced persons. Despite this burden, evidence for prevention programing in these populations is limited. This study aimed to inform the selection and implementation of suicide prevention strategies in refugee camps in Northwestern, Thailand - camps that had experienced recent spikes in suicides and suicide attempts at the time of the study. We leverage…
Wakȟáŋyeža (Little Holy One) - an intergenerational intervention for Native American parents and children
ClinicalTrials.gov: NCT04201184 . Registered 11 December 2019
Experiences of mental health and functioning among conflict-affected populations
Findings suggest a need for community-based programming that facilitates social adaptation, supports social network building, and helps engage conflict-affected people into mental health services. Programs that promote greater awareness, interaction, and understanding among the general public, military veterans, and IDPs are also warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Suicide Ideation and Depression Quality of Life Ratings in a Reservation-Based Community of Native American Youths and Young Adults
Suicide among adolescents is a significant public health concern in the U.S., especially within American Indian and Alaska Native (AIAN) communities. Lack of quality of life (QoL) estimates for both suicide ideation and depression specific to the AIAN population hinders the ability to compare interventions in cost-effectiveness analysis. We surveyed 200 AI youth and young adults from the Fort Apache Indian Reservation to estimate utility weights …
Development and Dissemination of a Strengths-Based Indigenous Children's Storybook
The traditions, strengths, and resilience of communities have carried Indigenous peoples for generations. However, collective traumatic memories of past infectious diseases and the current impact of the coronavirus disease 2019 (COVID-19) pandemic in many Indigenous communities point to the need for Indigenous strengths-based public health resources. Further, recent data suggest that COVID-19 is escalating mental health and psychosocial health in…
When less is more
Using Item Response Theory (IRT) we created shortened valid measures that can be used to help guide clinical decisions and function as longitudinal research tools. The results of this analysis demonstrate the reliability and validity of shortened scales in each of the two settings and an approach that can be generalized more broadly to help improve screening, monitoring, and evaluation of mental health and psychosocial programs globally
Adolescent Resilience in Northern Uganda
We investigated relations between prosocial behavior, perceived social support, and improvement in depression and anxiety symptoms over 6 months among 102 Acholi adolescent (14–17 years, 58% female adolescents) survivors of war and displacement in Northern Uganda. Adolescents were assessed using a locally developed screener. Regression analyses measured the association between resilience factors and mental health outcomes. Findings indicated that…
Utilizing broad‐based partnerships to design a precision approach to implementing evidence‐based home visiting
The aim of this paper is to describe a participatory process for adapting an implementation strategy, using a precision approach, for an evidence‐based home visiting program, Family Spirit. Family Spirit serves Native American and low‐income communities nationwide. To redesign Family Spirit's implementation strategy, we used workshops ( n = 5) with key stakeholders and conducted an online survey with implementers ( n = 81) to identify hypothesize…
Nurturing Innovation at the Roots
Nurturing Innovation at the Roots: The Success of COVID-19 Vaccination in American Indian and Alaska Native Communities Emily E. HarozPhD, MA, MHS, Christopher G. KempPhD, MPH, Victoria M. O'KeefePhD, MS, Katherine PocockPA-C, David R. WilsonPhD, Loretta ChristensenMD, MBA, MSJ, FACS, Melissa WallsMA, PhD, Allison BarlowPhD, and Laura HammittMD Affiliation Emily E. Haroz, Christopher G. Kemp, Victoria M. O'Keefe, Melissa Walls, Allison Barlow, an…
Development and Dissemination of a Strengths-Based Indigenous Children's Storybook
The traditions, strengths, and resilience of communities have carried Indigenous peoples for generations. However, collective traumatic memories of past infectious diseases and the current impact of the coronavirus disease 2019 (COVID-19) pandemic in many Indigenous communities point to the need for Indigenous strengths-based public health resources. Further, recent data suggest that COVID-19 is escalating mental health and psychosocial health in…
Adolescent Resilience in Northern Uganda
We investigated relations between prosocial behavior, perceived social support, and improvement in depression and anxiety symptoms over 6 months among 102 Acholi adolescent (14–17 years, 58% female adolescents) survivors of war and displacement in Northern Uganda. Adolescents were assessed using a locally developed screener. Regression analyses measured the association between resilience factors and mental health outcomes. Findings indicated that…
Cultural concepts of distress and psychiatric disorders
BACKGROUND: Burgeoning global mental health endeavors have renewed debates about cultural applicability of psychiatric categories. This study's goal is to review strengths and limitations of literature comparing psychiatric categories with cultural concepts of distress (CCD) such as cultural syndromes, culture-bound syndromes, and idioms of distress. METHODS: The Systematic Assessment of Quality in Observational Research (SAQOR) was adapted based…
A Common Elements Treatment Approach for Adult Mental Health Problems in Low- and Middle-Income Countries
Adaptation and testing of psychosocial assessment instruments for cross-cultural use
This paper describes the importance and process of adaptation and testing, illustrated by the experiences and results for selected instruments in this population
Thinking too much”
Local perceptions of the impact of group interpersonal psychotherapy in rural Uganda
Results suggest that providing treatment for depression in communities with high depression prevalence rates may lead to positive changes in a range of non-mental health outcomes
Development process of an assessment tool for disruptive behavior problems in cross-cultural settings
Systematic processes are needed to develop valid measurement instruments for disruptive behavior disorders (DBDs) in cross-cultural settings. We employed a four-step process in Nepal to identify and select items for a culturally valid assessment instrument: 1) We extracted items from validated scales and local free-list interviews. 2) Parents, teachers, and peers (n=30) rated the perceived relevance and importance of behavior problems. 3) Highly …
Development and cross-cultural testing of the International Depression Symptom Scale (IDSS)
The IDSS-G showed high internal consistency reliability ( α = 0.92), test-retest reliability ( r = 0.87), and inter-rater reliability ( ICC = 0.90). Strong correlations between the IDSS-G and PHQ-9, functioning, and suicidal ideation supported construct validity. Criterion validity was supported for use of the IDSS-G to identify people with a SCID diagnosed depressive disorder (major depression/dysthymia). The IDSS-G also demonstrated incremental…
How is depression experienced around the world? A systematic review of qualitative literature
Validation of a cross-cultural instrument for child behavior problems
While both the DBIS-N and the ECBI had high classification accuracy for local idioms for behavior problems, the DBIS-N had a more coherent factor structure and added predictive value above the ECBI. Items from the DBIS-N were more consistent with cultural themes identified in qualitative research, whereas multiple items in the ECBI that did not fit with these themes performed poorly in factor analysis. In conjunction with practical considerations…
Adaptation and testing of an assessment for mental health and alcohol use problems among conflict-affected adults in Ukraine
The findings support the reliability and validity of the assessment-the MHAI-for screening of common mental health problems among Ukrainian IDPs and veterans. Use of IRT shortened the instrument to improve practicality and potential sustainability
Experience versus diagnosis as the appropriate basis for assessment of depression
Identifying research priorities for psychosocial support programs in humanitarian settings
NGT and online surveys were effective methods to engage stakeholders in a priority setting exercise to development a research agenda. Information from this stage of the project will be combined with findings from a concurrent systematic review to form the base of a second phase of work, which will include the development and implementation of a research strategy to strengthen the evidence base for those prioritized interventions
Employing a sequential multiple assignment randomized trial (SMART) to evaluate the impact of brief risk and protective factor prevention interventions for American Indian Youth Suicide
Clinical Trials NCT03543865, June 1, 2018
When less is more
Using Item Response Theory (IRT) we created shortened valid measures that can be used to help guide clinical decisions and function as longitudinal research tools. The results of this analysis demonstrate the reliability and validity of shortened scales in each of the two settings and an approach that can be generalized more broadly to help improve screening, monitoring, and evaluation of mental health and psychosocial programs globally
Utilizing broad‐based partnerships to design a precision approach to implementing evidence‐based home visiting
The aim of this paper is to describe a participatory process for adapting an implementation strategy, using a precision approach, for an evidence‐based home visiting program, Family Spirit. Family Spirit serves Native American and low‐income communities nationwide. To redesign Family Spirit's implementation strategy, we used workshops ( n = 5) with key stakeholders and conducted an online survey with implementers ( n = 81) to identify hypothesize…
A randomized-controlled trial of community-based transdiagnostic psychotherapy for veterans and internally displaced persons in Ukraine
Standard CETA is more effective than brief CETA, but brief CETA also had significant effects compared with wait-controls. Given demonstrated effectiveness, CETA could be scaled up as an effective community-based approach
Planning for suicide prevention in Thai refugee camps
Suicide and associated behaviors represent a significant health disparity among refugees and displaced persons. Despite this burden, evidence for prevention programing in these populations is limited. This study aimed to inform the selection and implementation of suicide prevention strategies in refugee camps in Northwestern, Thailand - camps that had experienced recent spikes in suicides and suicide attempts at the time of the study. We leverage…
Wakȟáŋyeža (Little Holy One) - an intergenerational intervention for Native American parents and children
ClinicalTrials.gov: NCT04201184 . Registered 11 December 2019
Experiences of mental health and functioning among conflict-affected populations
Findings suggest a need for community-based programming that facilitates social adaptation, supports social network building, and helps engage conflict-affected people into mental health services. Programs that promote greater awareness, interaction, and understanding among the general public, military veterans, and IDPs are also warranted. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Suicide Ideation and Depression Quality of Life Ratings in a Reservation-Based Community of Native American Youths and Young Adults
Suicide among adolescents is a significant public health concern in the U.S., especially within American Indian and Alaska Native (AIAN) communities. Lack of quality of life (QoL) estimates for both suicide ideation and depression specific to the AIAN population hinders the ability to compare interventions in cost-effectiveness analysis. We surveyed 200 AI youth and young adults from the Fort Apache Indian Reservation to estimate utility weights …
Development and Dissemination of a Strengths-Based Indigenous Children's Storybook
The traditions, strengths, and resilience of communities have carried Indigenous peoples for generations. However, collective traumatic memories of past infectious diseases and the current impact of the coronavirus disease 2019 (COVID-19) pandemic in many Indigenous communities point to the need for Indigenous strengths-based public health resources. Further, recent data suggest that COVID-19 is escalating mental health and psychosocial health in…
Centering Indigenous Knowledges and Worldviews
Globally, Indigenous communities, leaders, mental health providers, and scholars have called for strengths-based approaches to mental health that align with Indigenous and holistic concepts of health and wellness. We applied the Indigenist Ecological Systems Model to strengths-based case examples of Indigenous youth mental health and wellness work occurring in CANZUS (Canada, Australia, New Zealand, and United States). The case examples include r…
Measuring the effects of the Covid-19 pandemic on Diné and White Mountain Apache school personnel, families, and students
The results of this study will inform the development or implementation of preventative interventions that may help Diné and Apache youth and their families recover from the negative impact of the COVID-19 pandemic, and positively impact their health and wellness
Home visitor perspectives on implementing a precision approach to home visiting in communities serving Native American families
Family Spirit (FS) is a federally endorsed evidence‐based home visiting programs serving as a key prevention strategy for expectant families and families with young children. Like other home‐visiting programs, it shares client challenges in retention and engagement during implementation. We assessed (1) the feasibility and acceptability of implementing a precision approach to FS; and (2) differences in approaches to FS delivery. Home visitors, se…
Medicine (29 works) · Psychology (27 works) · Psychiatry (21 works) · Mental health (18 works) · Clinical Psychology (16 works) · Clinical Psychology (11 works) · Indigenous Health, Education, and Rights (11 works) · Mental Health Treatment and Access (11 works) · Migration, Health and Trauma (10 works) · Anxiety (9 works)