Moving from ethnography to epidemiology: Lessons learned in Appalachia

• Type of Material: Article
• Authors: Ryan A. Brown, Northwestern University; Jennifer Kuzara, Emory University; William E. Copeland, Duke University; E. Jane Costello, Duke University; Adrian Angold, Duke University; Carol Worthman, Emory University
• Language: English
• Date: 2009-01
• Publisher: Taylor & Francis
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2009 Taylor & Francis
• Final Published Version (URL): http://dx.doi.org/10.1080/03014460902832942
• Title of Journal or Parent Work: Annals of Human Biology
• ISSN: 0301-4460
• Volume: 36
• Issue: 3
• Start Page: 248
• End Page: 260
• Grant/Funding Information: Research was supported by the W.T. Grant Foundation (DS804 383-2854 to Costello, Worthman, and Brown), the National Institutes of Health (NIMH NRSA 5 F31 MH064253-02 to Brown), and a Russell Sage Foundation Faculty Scholarship (Worthman).
• Keywords: Appalachia; American Indian; population health; life course; depression
• Research Categories: Health Sciences, Mental Health; Anthropology, Medical and Forensic; Health Sciences, Epidemiology

Abstract

Background: Anthropologists are beginning to translate insights from ethnography into tools for population studies that assess the role of culture in human behavior, biology, and health. Aim: We describe several lessons learned in the creation and administration of an ethnographically-based instrument to assess the life course perspectives of Appalachian youth, the Life Trajectory Interview for Youth (LTI-Y). Then, we explore the utility of the LTI-Y in predicting depressive affect, controlling for prior depressed mood and severe negative life events throughout the life course. Subjects and methods: In a sample of 319 youth (190 White, 129 Cherokee), we tested the association between depressive affect and two domains of the LTI-Y - life course barriers and milestones. Longitudinal data on previous depressed mood and negative life events were included in the model. Results: The ethnographically-based scales of life course barriers and milestones were associated with unique variance in depressed mood, together accounting for 11% of the variance in this outcome. Conclusion: When creating ethnographically-based instruments, it is important to strike a balance between detailed, participant-driven procedures and the analytic needs of hypothesis testing. Ethnographically-based instruments have utility for predicting health outcomes in longitudinal studies.