Fort Belknap Reservation Map
Map by Kristen Drumheller
Brushing Lesson at Fort Belknap

The Fort Peck Reservation. (Photo by Monica Skewes)

Elizabeth Rink

Project Leader Elizabeth Rink, Ph.D., MSW
MSU Department of Health and Human Development
Curriculum Vitae


The rate of sexually transmitted infections (STIs) on the Fort Peck Reservation is roughly three times higher than that for the general U.S. population. Unplanned teen pregnancy rates are also significantly higher.

The objective of the Fort Peck Sexual Health Project is to identify a multitude of factors influencing sexual and reproductive health among 15- to 18-year-old adolescents living on the reservation, which is home to the Assiniboine and Sioux tribes. The study hypothesizes that high STI rates and unplanned pregnancies among these tribal communities are a marker for deeper underlying health issues operating and interacting at the individual, family, community, and environmental levels.

Using a community-based participatory research framework, this project examines several interrelated ecological factors that are likely to be influencing the sexual risk-taking behaviors of American Indian youth. The current research builds on Dr. Rink’s decade of work on the Fort Peck Reservation, including two previous CBPR projects: the Fort Peck Men’s Sexual Health Study and the Fort Peck Ceremony of Research Project.

The four primary aims of the current project are:

  • Aim 1: To identify the cognitive behavioral factors contributing to sexual risk-taking behaviors among male and female Native American adolescents.
  • Aim 2: To examine which social and cultural norms contribute to sexual risk-taking behaviors among male and female Native adolescents, including parenting and transmission of parental values, cultural beliefs about the value of children, attitudes and beliefs about sex, and the traditional and contemporary religious belief systems with regard to sex.
  • Aim 3: To identify the environmental and contextual factors (such as free time, relationships with peers, parties and access to drugs and alcohol, and limits on access to family planning services) that might contribute to sexual risk-taking behaviors among male and female Native American adolescents.
  • Aim 4: To develop and pilot an intervention that incorporates findings from Aims 1-3. The Fort Peck Sexual Health Project uses a concurrent qualitative and quantitative research design involving focus groups, key informant interviews, and a survey to inform the design, implementation, and evaluation of a sexual and reproductive health intervention.

Selected Project Accomplishments to Date

  • Established collaboration with Fort Peck Community College (FPCC) and a research team of MSU personnel and FPCC partners.
  • Convened a five-member community advisory board (CAB), which has held quarterly meetings since the project’s beginning. All CAB members are trained in community-based participatory research.
  • Conducted 10 focus groups among 50 tribal members.
  • Completed 30 key informant interviews.
  • Completed a survey of 15- to 18-year-olds in community schools, based on the results of the focus groups and key informant interviews.

Related Publications and Presentations (Selected)

Rink, E., Bird, E. A., FourStar, K., Ricker, A., Runs-Above/Meyers, W., & Hallum-Montes, R. (2016). Partnering with American Indian communities in strength-based collaborative health research: Guiding principles from the Fort Peck Ceremony of Research Project. American Indian and Alaska Native Mental Health Research, 23(3): 187-205.

Rink, E., FourStar, K., & Anastario, M. (in press). The relationship between pregnancy prevention and STI/HIV prevention and sexual risk behavior among American Indian men. Journal of Rural Health.

Rink, E., Ricker, A., FourStar, K., & Anastario, M. Unzip the truth: The Fort Peck men’s sexual health intervention and evaluation study. Manuscript submitted for publication.

Rink, E., Ricker, A., FourStar, K., & Hallum-Montes, R. “A balance that we walk”: Characteristics, attributes and behaviors that promote healthy American Indian heterosexual couple relationships. Manuscript submitted for publication.

Rink, E., Anastario, M., & FourStar, K. (2014). Perceived level of relationship commitment and condom use among American Indian men. Journal of Immigrant and Minority Health. doi: 10.007/s10903-014-0058-z.

Dick, R., Rink, E., & FourStar, K. (2014). The role of relationship and other factors associated with condom use intention among young American Indian men ages 18 to 24 years old. Journal of Health Disparities Research and Practice, 7(1): 72–89.

Anastario, M., Rink, E., & FourStar, K. (2013). Sexual risk behavior and symptoms of historical loss in American Indian men. Journal of Community Health. doi: 10.1007/s10900-013-9695-8.

Rink, E., FourStar, K., Dick, R., Gesink, D., & Jewett, L. (2012). Concepts of historic trauma and loss and pregnancy prevention among Native American men. Journal of Native American and Alaska Native Mental Health Research, 19(1), 57–75.

Rink, E., FourStar, K., Medicine Elk, J., Dick, R., Jewett, L., & Gesink, D. (2012). Pregnancy prevention among Native American men ages 18 to 24: The role of mental health and intention to use birth control. American Journal of Men’s Health, 64, 324–330.

Christopher, S., Saha, R., Lachapelle, P., Jennings, D., Wagner, S., Copper, C., Cummins, C., Eggers, M., FourStar, K., Harris, K., King, M., Kuntz, S., LaFromboise, V., LaVeaux, D., McDonald, T., Realbird, J., Rink, E., Webster, L., Colclough, Y. (2011). Applying indigenous CBPR principles to partnership development in health disparities research. Family and Community Health Journal, 34(3), 246–255.

Investigator Spotlight

Since 2007, Dr. Rink also has conducted research in Greenland examining sexual and reproductive health among the Inuit. Her work using community-based participatory research on the Fort Peck Reservation dates to 2006 and eventually led to the successful Fort Peck Men’s Sexual Health Study. During the course of that earlier project, tribal leaders asked her to expand her research into what has become her latest study.

“They said, ‘We really want you to work with women too, and we want you to do research on younger people,’” Rink recalls. “‘We really think these problems start in adolescence.’ So it was the Fort Peck Tribal Council that got our new study going.”

To Learn More

Read more about the project in this excerpt from the Spring 2016 CAIRHE Newsletter.

Watch Agicida Cande (Warrior's Heart), a film resulting from the Fort Peck Men's Sexual Health Study. (Narrated by Elizabeth Rink and Kris FourStar. Created by Justin Lubke of Story Road Films.)