Using Intervention Mapping to Develop a Trauma-Informed Sexual Health Program for Native American Youth

Native American adolescents and young adults experience persistent sexual and reproductive health inequities shaped by collective trauma, historical oppression, and ongoing structural violence. Although culturally responsive sexual health programs have increased in recent years, few interventions focus specifically on older adolescent and young adult women or intentionally integrate trauma-informed approaches. This article describes using Intervention Mapping to design a culturally relevant, trauma-informed sexual and reproductive health education intervention for Native American older adolescent and young adult women aged 15 to 25 years. Steps 1 to 4 of the Intervention Mapping framework were applied to guide intervention development. Activities included identifying sexual and reproductive health problems and quality-of-life outcomes, specifying behavioral and environmental determinants, developing behavioral and environmental change outcomes and performance objectives, constructing matrices of change objectives, and selecting theory- and evidence-based methods and practical applications. These processes were informed by prior qualitative research with sexual and reproductive health professionals and a systematic review of trauma-informed sexual health education interventions. The Intervention Mapping process resulted in a comprehensive logic model of the problem, detailed matrices linking determinants to change objectives, and draft program components, materials, and facilitator protocols. The resulting intervention plan centers community voice, participatory learning, cultural teachings, and trauma-informed practices. This work contributes to a theory-driven approach to developing culturally grounded sexual health education for Native American young women. The intervention plan provides a foundation for future pilot testing, evaluation, and adaptation in Tribal and Native-serving communities with implications for advancing equity-focused sexual health promotion.