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. 2009 May-Jun;36(3):248-60, 2 p following 260.
doi: 10.1080/03014460902832942.

Moving from ethnography to epidemiology: lessons learned in Appalachia

Ryan A Brown  1 , Jennifer Kuzara, William E Copeland, E Jane Costello, Adrian Angold, Carol M Worthman
Affiliations

Moving from ethnography to epidemiology: lessons learned in Appalachia

Ryan A Brown et al. Ann Hum Biol. 2009 May-Jun.

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 symptoms, controlling for prior depressive symptoms and severe negative life events throughout the life course.

Subjects and methods: In a sample of 319 youths (190 White, 129 Cherokee), we tested the association between depressive symptoms and two domains of the LTI-Y - life course barriers and milestones. Longitudinal data on prior depressive symptoms 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 depressive symptoms, 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.

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Figures

Figure 1
Figure 1
Note: The items located within the x and y axes are the milestones Rusty included as “most essential” to achieve in life. Vertically, they are in order of ranked importance. On the y axis is Rusty's perceived ideal age for achieving each milestones. In parentheses are the ranked difficulties of achieving each item (1 is hardest, 12 is easiest). Rusty has already achieved the items with a check mark, and has yet to achieve the items with an “X.”
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