Protective assets for non-use of alcohol, tobacco and other drugs among urban American Indian youth in Oklahoma

Profiles of Ecosystemic Resilience and Risk: American Indian Adolescent Substance Use during the First Year of the COVID-19 Crisis

The COVID-19 pandemic has caused an unprecedented disruption to the lives of American Indian (AI) adolescents. While reservation-area AI youth already have a higher risk of substance use (SU) compared to their non-AI peers, COVID-19 stressors likely exacerbated this risk. However, COVID-19-specific and general resilience factors may have buffered against increased SU over the course of the pandemic. Using a person-centered, ecosystemic framework of resilience, we used latent profile analysis to identify ecosystemic resilience profiles indicated by general and COVID-19-specific risk and resilience factors, then examined inter-profile changes in alcohol and cannabis use after the onset of the COVID-19 pandemic from the spring of 2020 to the spring of 2021. The sample was 2218 reservation-area AI adolescents (7-12th grade; schools = 20; M_age = 15, SD = 1.7; 52% female). Four profiles emerged: Average Risk and Resilience, High Resilience, Low Resilience, and High Risk. Adolescents with a High-Risk profile demonstrated increases in alcohol and cannabis use, while High Resilience youth demonstrated decreases. These findings support the hypothesized COVID-19-specific ecosystemic resilience profiles and the application of a person-centered ecosystemic framework to identify which AI adolescents are most likely to experience substance use changes during a life-altering crisis like COVID-19.

"It's in the family circle": Communication promoting Indigenous family resilience

OBJECTIVE

We use the Framework of Historical Oppression, Resilience, and Transcendence (FHORT) to investigate the framework's core concept of family resilience and related protective and promotive factors that contribute to greater resilience, namely communication.

BACKGROUND

Scant research has examined communication in Indigenous families; yet general research suggests that family communication is a prominent aspect of family resilience.

METHODS

In this exploratory sequential mixed-methods study with data from 563 Indigenous participants (n = 436 qualitative and n = 127 quantitative survey), thematic reconstructive analysis was used to qualitatively understand participants' experiences of family communication and quantitatively examine protective factors for family resilience.

RESULTS

The following themes related to family communication as a component of family resilience emerged from qualitative analysis: "It's in the Family Circle": Discussing Problems as a Family with the subtheme: Honesty between Partners; (b) "Never Bring Adult Business into Kids' Lives": Keeping Adult Conversations Private; and (c) "Trust Us Enough to Come to Us": Open Communication between Parents and Children. Regression analysis indicated that higher community and social support, relationship quality, and life satisfaction were associated with greater family resilience.

CONCLUSIONS

Positive communication practices are a strong component of resilience, healthy Indigenous families. Promotive factors at the community (social and community support), relational (relationship quality), and individual (life satisfaction) levels positively contribute to Indigenous family resilience.

IMPLICATIONS

Clinical programs providing practical tools to foster healthy communication - both about difficult topics as well as positive topics - are promising avenues to foster resilience.

Mental health, family functioning, and sleep in cultural context among American Indian/Alaska Native urban youth: A mixed methods analysis

Mental health problems contribute significantly to the global burden of disease. Driven in part by family stressors and insufficient sleep, mental health disproportionately affects low SES urban adolescents. In the United States, American Indian/Alaska Native (AI/AN) youth exhibit excessively high rates of mental health problems. Family functioning is strongly associated with adolescent mental health, and sleep problems may serve as a pathway between family functioning and mental health. Using mixed methods we examine the associations among family functioning, subjective- and actigraphy-measured sleep, mental health (depressive and anxiety symptoms), and cultural identity in a sample of urban AI/AN youth. All participants (N = 142) completed surveys; a random subsample (n = 26) completed qualitative interviews to assess family and cultural dynamics related to sleep, which informed hypothesized direct and indirect effects that were tested using survey data. Narratives identified mechanisms of family cohesion (e.g., daily interactions that build perceived family togetherness and family-centered traditional activities) and the role that family cohesion plays in sleep (e.g., ensuring stability of sleep environments). Path analysis showed direct effects of improved family functioning on fewer depressive and anxiety symptoms, and indirect effects through lower self-reported sleep disturbance (but not through greater actigraphy-measured sleep duration or efficiency). Cultural identity did not moderate effects in quantitative tests. Our findings illustrate the complex associations among family functioning, sleep, and mental health in AI/AN youth. Family-based interventions to improve adolescent mental health should address modifiable intervention targets such as sleep, and address sources of both risk and resilience relevant to urban AI/AN families, including extended family and cultural practices.

Empowering our people: Predictors of retention in an STI risk reduction program among rural Native Americans with binge substance use

PURPOSE

Substance use and sexual risk-taking have been shown to co-occur. Programs focused on sexually transmitted infections (STIs) reduction may benefit substance-using, particularly binge substance-using, adults. This is especially true for rural Native American communities who endure sexual and substance use disparities and have few STI risk reduction programs. This study explores factors predicting retention in an STI risk reduction program among rural Native adults engaged in binge substance use.

METHODS

We analyzed data from 150 Native adults ages 18-55 participating in an evaluation of "EMPWR," a 2-session STI risk reduction program in a rural, reservation-based community. Multivariate logistic regression models were used to estimate associations between independent variables and program completion across demographics, sexual behaviors, substance use behaviors, mental health, recent health care utilization, and perceived enculturation and discrimination.

FINDINGS

The sample was 49.2% (n = 59) female with a mean age of 33.61 years (SD = 8.25). Twenty-six completed only the first EMPWR session, 94 completed both EMPWR sessions, and 30 were randomized but completed 0 sessions. Being married/cohabiting (adjusted odds ratio [AOR] = 6.40, P = .0063) and living with an older generation (AOR = 4.86, P = .0058) were significantly associated with higher odds of completing EMPWR.

CONCLUSIONS

Findings provide insight on factors driving retention of Natives with recent binge substance use in STI risk reduction programming. An important contribution to Native health literature is that living with an older generation positively predicted EMPWR program completion, suggesting that STI risk reduction programs should harness the strength of families to ensure program attendance and optimize impacts in rural reservation contexts.

Latent Class Analysis and Predictors of Marijuana Use among Reservation-based American Indian High School Students

American Indian (AI) youth residing on reservations report higher rates of marijuana use compared to national youth. Latent class analysis (LCA) was used to identify unique types of marijuana use among 2,884 AI high school students surveyed from 26 schools across six indigenous geographic regions. Predictors of class membership were then assessed using social, cultural, and individual measures relevant to adolescent substance use. Classes and predictors were examined separately for males and females. Four-class models fit the data best for both male and female AI students. Classes differed by sex, as did predictors. Overall, social predictors related to family and peers and the individual predictor, using marijuana to cope, were the best predictors of class membership. Based on these results, prevention and intervention efforts should provide alternative coping methods for these adolescents who often live in difficult situations, and should focus on encouraging parents to effectively monitor their adolescent children and communicate clear sanctions against marijuana use.

Variations in risk and promotive factors on substance use among urban American Indian youth

Although roughly 70% of the American Indian and Alaska Native (AI) population live in urban areas, research is scarce regarding this population. As a consequence, there is limited understanding about the salient socioenvironmental factors that aid in preventing substance use among urban AI communities. This study utilized a statewide, cross-sectional, school-based survey of urban AI adolescents (N = 2,375) to (a) examine the associations between substance use and risk and promotive factors within the family and peer group, and (b) explore how these associations vary by subgroups (gender, racial/ethnic background, and grade level). Results suggest that risk factors-familial substance use and antisocial peer affiliation-were associated with higher alcohol, cigarette, and marijuana use. However, these findings varied by subgroup. For males, involvement with antisocial peers was associated with greater marijuana use. Involvement with antisocial peers was also positively associated with alcohol and marijuana use for multiracial/multiethnic AI adolescents and those adolescents in 10th and 12th grades. The promotive factors-supportive family environment and prosocial peer affiliation-were not universally associated with lowered substance use by subgroup. This study advances understandings of the risk and promotive factors important in reducing and preventing substance use among urban AI adolescents. Experiencing familial substance use and affiliating with antisocial peers were the salient factors associated with increased substance use, particularly for urban AI adolescents who are older, male, and with multiracial/multiethnic AI backgrounds.

Illicit drug use among students of a university in Southern Brazil

OBJECTIVE

To describe drug consumption and the co-occurrence use of more than one illegal drug as well as associated factors in freshmen at a public university in Southern Brazil.

METHODS

Cross-sectional study with census of students entering undergraduate courses in 2017. A total of 1,788 university students answered questions about illicit drug use. For analysis, ordinal logistic regression was used.

RESULTS

Marijuana was the most consumed drug (lifetime: 42.1%; 30-day use: 22.7%), followed by hallucinogens (lifetime: 13.1%, 30-day use: 2.8%). Rates for lifetime use of 0, 1 and 2 or more drugs were 56.2%, 23.3% and 20.4%, respectively, and were associated with men (OR = 2.2; 95%CI:1.4–3.5), being at least 23 years old (OR = 2.7; 95%CI: 1.4–5.1), under 18 years old first experimentation with drugs (OR = 2.3; 95%CI: 1.3–3.9) and living with friends (OR = 2.0; 95%CI: 1.2–3.4). Rates for 30-day use of 0, 1 and 2 or more drugs were 76.8%; 18.1% and 5.1%, respectively, and were associated with being single, separated or widowed (OR = 3.2; 95%CI: 1.4–7.0), lower socioeconomic classes (OR = 0.3; 95%CI: 0.1–1.1; p = 0.001), under 18 years old first experimentation with drugs (OR = 1.8; 95%CI: 1.1–2.9) and living with friends (OR = 1.8 95%CI: 1.2–2.8).

CONCLUSION

Results indicate that students are at greater risk of illicit drug-related health problems. Thus, a better understanding of this consumption should be pursued, as well as the development of a prevention plan.

Family as the Conduit to Promote Indigenous Women and Men's Enculturation and Wellness: "I wish I had learned earlier"

The purpose of this article is to explore how food and other cultural traditions promote wellness, cultural continuity, enculturation, and family resilience within tribal communities in the U.S. Using the Framework of Historical Oppression, Resilience, and Transcendence (FHORT), this critical ethnography examines Indigenous peoples' perspectives on and experiences with food and cultural traditions. Thematic analysis of data from 436 participants (approximately 2/3rds of which were women) across two Southeastern tribes revealed a theme of "fostering the transmission of tribal knowledge and intergenerational family bonding." Traditions such as dancing, food, sewing, beadwork, basket-weaving, music, and tribal sports were some important facets of tribal culture that participants described. Food and cultural practices promoted wellness, pro-social values, and health by fostering physical activity, traditional food practices, enculturation, and social support. Cultural practices offset historical oppression and health disparities. Programs that utilize the strengths of experiential learning through family and cultural practices are highly recommended.

Factors Influencing Smoking Among Indigenous Adolescents Aged 10–24 Years Living in Australia, New Zealand, Canada, and the United States: A Systematic Review

Introduction

Smoking rates are higher among Indigenous populations in most high-income countries with initiation primarily occurring in adolescence for all population groups. This review aims to identify protective and risk factors for smoking behavior among Indigenous adolescents and young adults.

Aims and Methods

We searched Medline, Embase, and Psychinfo for all original research published between January 2006 and December 2016 that reported influences on smoking for Indigenous adolescents or young adults aged 10–24 living in Australia, New Zealand, Canada, and the United States (US). Extracted data were coded to individual, social, and environmental level categories using a modified Theory of Triadic Influence framework.

Results

A total of 55 studies were included, 41 were descriptive quantitative and 14 qualitative, and 26 included Indigenous participants only. The majority were from the US (32). Frequently reported influences were at the individual and social levels such as increasing age; attitudes and knowledge; substance use; peer and family relationships; smoking norms; mental health; physical activity. At the environmental level, smoke-free spaces; second-hand smoke exposure; high community level prevalence; and social marketing campaigns were also frequently reported. Some studies referenced price, access, and traditional tobacco use. Few reported historical and cultural factors.

Conclusions

Young Indigenous people experience similar influences to other populations such as smoking among family and friends. Greater youth smoking is related to broader community level prevalence, but few studies explore the distal or historical contributing factors such as traditional tobacco use, colonization, experiences of intergenerational trauma and discrimination, or the role of cultural connection.

Implications

This review identified a range of factors that influence Indigenous youth smoking and contributes to an understanding of what prevention measures may be effective. Youth tobacco use occurs alongside other substance use and may also serve as an indicator of mental health. Comprehensive community-based programs that work more broadly to address the risk factors related to tobacco, including improving youth mental health, will be important for other behaviors as well. This research highlights the importance of social influence and need for ongoing denormalization of smoking. Future Indigenous led and community owned research is needed to identify likely protective cultural factors.

Classes of drinking motives among American Indian youth drinkers

Research exploring American Indian (AI) youth drinking motives and their relation to negative outcomes is critical due to higher rates of alcohol use and early exposure to intoxication in the population. The purpose of this study is to explore classes of drinking motives as they relate to heavy episodic drinking, perceived discrimination, religious importance, ethnic identity, and ethnic pride. This study is part of an ongoing epidemiologic and etiologic investigation of substance use among AI youth drinkers living on or near reservations (n = 1,934, Mage = 15.31). A latent class analysis (LCA) was conducted to discern latent classes of drinking motives. Once latent classes were identified, differences in perceived discrimination, ethnic pride, ethnic identity, religious importance, and heavy episodic drinking were tested. A 2-class solution provided the best overall model fit to the data. The higher coping and enhancement motive class was associated with significantly greater heavy episodic drinking, perceived discrimination, and ethnic identity compared with the low motive class. Further, the class structure did not differ between 7th and 8th graders and 9th-12th graders. Results indicate that among AI youth, the class with strong motives to drink for coping or enhancement had higher ethnic identity, greater risk of heavy episodic drinking, and greater perceived discrimination compared with the class with low motives. Future research should examine additional factors and stressors that may be associated with these classes of drinking motives and are unique to the AI population. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Exploration of Pathways to Binge Drinking Among American Indian Adolescents

Binge drinking is a serious public health problem among American Indian adolescents, yet few theoretical models specific to this population and type of problematic drinking have been tested. The White Mountain Apache Tribe has begun surveillance of binge drinking and a related line of research to inform tailored prevention efforts. The goal of this paper is to use structural equation modeling to understand the relationships between different individual, family, peer, and cultural factors that predict or protect against binge drinking behavior among Apache adolescents ages 10-19 years old. A cross-sectional case-control study was completed with N = 68 Apache adolescents who required medical attention due to a recent binge event (past 90 days) and N = 55 controls with no lifetime history of binge drinking. The hypothesized model was estimated with Mplus using the WLSMV robust least squares estimator. In the final model, stressful life events were related to family functioning and peer relationships. In turn, family functioning affected peer relationships and adolescent impulsivity, which were both associated with greater risk of binge drinking. The path between peer relationships and having engaged in binge drinking was statistically significant for those expressing lower cultural identity, but not for those reporting higher cultural identity. Findings suggest preventive interventions should emphasize teaching coping skills to manage life stressors and handle impulsivity, strengthening families, and changing peer dynamics with social network-based approaches as well as social skill training. The model highlights the potentially important role of culture in strengthening positive peer relationships to reduce binge drinking risk.

Developmental Assets and Risky Sexual Behaviors among American Indian Youth

This study examined the relationship between developmental assets during early and mid-adolescence and early adult sexual behaviors among American Indians using a subsample from the National Longitudinal Study of Adolescent Health (N = 465). Grounded in an assets framework, the authors explored the protective role of personal, family, school, and community assets as well as cumulative assets for sexual behaviors including early sexual debut, number of sexual partners, and frequency of condom use. The results indicated that certain assets during early and mid-adolescence, such as self-control, family support, and school attachment were protective for various risky sexual behaviors in early adulthood. Furthermore, cumulative assets emerged as an important predictor of sexual behaviors. These findings highlight the utility of applying a developmental asset framework to understand protective factors among American Indian youth.

Religious and Spiritual Practices Among Home-less Urban American Indians and Alaska Natives with Severe Alcohol Problems

Engagement in religious and spiritual practices may be protective for homeless individuals with alcohol-related problems. However, little is known in this regard for urban-dwelling American Indians and Alaska Natives (AI/ANs) who have disproportionately high rates of homelessness and co-occurring alcohol use problems. Using secondary data from a nonrandomized controlled study testing a Housing First intervention, AI/AN participants (n = 52) and non-AI/AN participants (n = 82) were compared on demographic variables, alcohol use problems, religious affiliations, and religious/spiritual practices (importance, frequency, and type). AI/ANs who engaged in Native-specific independent spiritual practices had significantly lower alcohol use frequency in comparison to AI/ANs who did not.

Culturally Relevant Protective and Risk Factors of Youth Risk Behaviors Among Pakistani and Indian Students in Hong Kong: A Focus Group Study

PURPOSE

The risk behaviors of Hong Kong ethnic minority students are understudied. This exploratory qualitative study aimed to explore culturally nuanced factors for the development and prevention of risk behaviors among Pakistani and Indian students in Hong Kong.

METHOD

Twenty-three students participated in four focus groups. All interviews were transcribed verbatim and analyzed using thematic analysis.

RESULTS

The participants reported bullying, delinquency, gambling, alcohol, cigarette, and drug uses as risk behaviors. Four themes emerged in the development and prevention of risk behaviors: (a) Parental and peer influence, (b) An unsafe community environment were perceived by the participants as essential factors for the development of risk behaviors, (c) Parental monitoring, and (d) Strong religious beliefs were believed as protective factors for the prevention of risk behaviors.

CONCLUSION

Further research and practice may investigate and focus on the factors embedded in the Hong Kong ethnic minorities' sociocultural contexts to prevent risk behaviors.

Substance Use Profiles of Urban American Indian Adolescents: A Latent Class Analysis

A growing majority of American Indian adolescents now live in cities and are at high risk of early and problematic substance use and its negative health effects.

OBJECTIVE

This study used latent class analysis to empirically derive heterogeneous patterns of substance use among urban American Indian adolescents, examined demographic correlates of the resulting latent classes, and tested for differences among the latent classes in other risk behavior and prosocial outcomes.

METHOD

The study employed a representative sample of 8th, 10th, and 12th grade American Indian adolescents (n = 2,407) in public or charter schools in metropolitan areas of Arizona in 2012. Latent class analysis examined eight types of last 30 day substance use.

RESULTS

Four latent classes emerged: a large group of "nonusers" (69%); a substantial minority using alcohol, tobacco, and/or marijuana [ATM] (17%); a smaller group of polysubstance users consuming, alcohol, tobacco, marijuana, other illicit drugs, and prescription or OTC drugs in combination (6%); and a "not alcohol" group reporting combinations of tobacco, marijuana, and prescription drug use, but rarely alcohol use (4%). The latent classes varied by age and grade level, but not by other demographic characteristics, and aligned in highly consistent patterns on other non-substance use outcomes. Polysubstance users reported the most problematic and nonusers the least problematic outcomes, with ATM and "not alcohol" users in the middle.

CONCLUSIONS

Urban AI adolescent substance use occurs in three somewhat distinctive patterns of combinations of recent alcohol and drug consumption, covarying in systematic ways with other problematic risk behaviors and attitudes.

American Indian elders share personal stories of alcohol use with younger tribal members

In this Great Lakes Indian reservation qualitative study we utilized focus groups in the form of talking circles to elicit tribal members' views of alcohol use. We report on how the elder participants utilized the talking circles to inform the youth of the deleterious effects of alcohol use and abuse. Indigenous research methods were utilized so elder tribal members were consulted about the study; an elder was hired as a research associate; youth were hired as note takers/observers; and the 2-hour groups were led by a tribal community member. Demographic data were gathered, and a semistructured guide with substance use questions was utilized. Tribal members, 30 females and 19 males, age 12 to 78 participated in 8 talking circles (N = 49). Tribal elders unexpectedly utilized the format as an opportunity for cross-generational storytelling to convey their own oral histories of the harmful effects of alcohol use for the younger participants. They shared personal pathways to quitting or to a reduction in drinking with messages aimed at preventing the youth from initiating drinking. A shortage of American Indian (AI) substance abuse treatment programs that are culturally relevant exists. The widespread and renewed use of cross-generational talking circles could serve as an inexpensive substance abuse prevention and intervention treatment modality for AI youth. The elders' stories highlight the need to rejuvenate traditional methods of healing among AIs to reduce the initiation and/or harmful effects of overuse of alcohol among AI youth.

Risk and protective factors for heavy binge alcohol use among American Indian adolescents utilizing emergency health services

BACKGROUND

American Indian (AI) adolescents are disproportionately burdened by alcohol abuse and heavy binge use, often leading to problematic drinking in adulthood. However, many AI communities also have large proportions of adults who abstain from alcohol.

OBJECTIVE

To understand these concurrent and divergent patterns, we explored the relationship between risk and protective factors for heavy binge alcohol use among a reservation-based sample of AI adolescents.

METHODS

Factors at individual, peer, family, and cultural/community levels were examined using a cross-sectional case-control study design. Cases were adolescents with recent heavy binge alcohol use that resulted in necessary medical care. Controls had no lifetime history of heavy binge alcohol use. 68 cases and 55 controls were recruited from emergency health services visits. Participants were 50% male; average age 15.4 years old, range 10 to 19. Independent variables were explored using logistic regression; those statistically significant were combined into a larger multivariate model.

RESULTS

Exploratory analyses showed adolescents who were aggressive, impulsive, had deviant peers, poor family functioning or more people living at home were at greater risk for heavy binge alcohol use. Protective factors included attending school, family closeness, residential stability, social problem-solving skills, having traditional AI values and practices, and strong ethnic identity. Confirmatory analysis concluded that school attendance and residential stability reduce the probability of heavy binge alcohol use, even among those already at low risk.

CONCLUSIONS

Findings deepen the understanding of AI adolescent heavy binge alcohol use and inform adolescent intervention development fostering trajectories to low-risk drinking and abstinence.

EXPLAINING THE ASSOCIATION BETWEEN GENDER AND SUBSTANCE USE AMONG AMERICAN INDIAN ADOLESCENTS: AN APPLICATION OF POWER-CONTROL THEORY

This study evaluates the utility of Hagan's power-control theory for explaining substance use behaviors for a sample of American Indian adolescent males and females. Consistent with the theory, we found that patriarchal family form and the affective bond between father and daughter were significant predictors of female substance use behaviors. Compared to results from an analysis of non-Hispanic whites, these results reveal the importance of testing generalist explanations of deviant behavior across racial and ethnic groups. Our findings encourage a more in depth consideration of the gendered nature of work, it's association with socialization and control in American Indian families, and it's impact on gender differences in substance use and delinquent behaviors.

Prospective associations among youth assets in young adults and tobacco use

BACKGROUND

Developmental assets protect adolescents from tobacco use; however, their influence during the transition to young adulthood is unknown.

PURPOSE

To determine the prospective associations among assets and tobacco use in older adolescents and young adults.

METHODS

Prospective analyses were conducted using five waves of annual data collected from 467 randomly selected ethnically diverse youth (baseline age, 15-17 years) from 2003 to 2008. Logistic regression was conducted in 2013 to prospectively examine associations between ten Wave 1 assets with no tobacco use in the past 30 days over the five waves of the study (no use). Assets that were significantly associated with no use were included in a second analysis to examine the cumulative effect of Wave 1 assets on no use.

RESULTS

Youth who possessed Family Communication, Relationship with Mother, Aspirations for the Future, Parental Monitoring, or Responsible Choices assets had significantly higher odds of no tobacco use. There were significant interactions between Relationship with Father, Non-Parental Adult Role Models, Future Educational Aspirations, and Peer Role Models assets and family structure, gender, or both. There was a significant interaction between cumulative assets and family structure. For youth in two-parent households at Wave 1, those with more assets had significantly greater odds of reporting no tobacco use over five waves compared to those with the fewest assets.

CONCLUSIONS

The influence of assets in adolescents can influence tobacco use into young adulthood. Family structure and gender can influence the asset-tobacco use relationship.

The influence of assets and environmental factors on gender differences in adolescent drug use

For adolescents, illicit drug use remains a significant public health problem. This study explored prospectively the differential effects of 17 youth assets and 5 environmental factors on drug use in adolescent males and females (Youth Asset Study - a 5-wave longitudinal study of 1117 youth/parent pairs). Baseline analyses included 1093 youth (53% female). Mean age was 14.3 years (SD = 1.6) and the youth were 40% Non-Hispanic White, 28% Hispanic, 24% Non-Hispanic Black, and 9% Non-Hispanic other. Analyses revealed that 16 assets for males and 15 for females as well as the total asset score were prospectively associated with no drug use. No environmental factors were prospectively associated with any drug use for males, and for a subset of females, only Neighborhood Support was significant. This study confirms and extends previous work regarding youth drug use by recognizing the importance of the protective effect of assets for both males and females.

Family Structure and Adolescent Alcohol Use Problems: Extending Popular Explanations to American Indians

Competing explanations of the relationship between family structure and alcohol use problems are examined using a sample of American Indian adolescents from the National Longitudinal Study of Adolescent Health. Living in a single-parent family is found to be a marker for the unequal distribution of stress exposure and parental alcohol use, but the effects of other family structures like non-parent families and the presence of under 21-year-old extended family or non-family members emerge or remain as risk or protective factors for alcohol use problems after a consideration of SES, family processes, peer socialization, and social stress. In particular, a non-parent family structure that has not been considered in prior research emerged as a protective family structure for American Indian adolescent alcohol use problems.

Spirituality and religion: intertwined protective factors for substance use among urban American Indian youth

BACKGROUND AND OBJECTIVE

This article explores the aspects of spirituality and religious involvement that may be the protective factors against substance use among urban American Indian (AI) youth.

METHODS

Data come from AI youth (N = 123) in five urban middle schools in a southwestern metropolis.

RESULTS

Ordinary least squares regression analyses indicated that following Christian beliefs and belonging to the Native American Church were associated with lower levels of substance use.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

Following AI traditional spiritual beliefs was associated with antidrug attitudes, norms, and expectancies. Having a sense of belonging to traditions from both AI cultures and Christianity may foster integration of the two worlds in which urban AI youth live.

A comparison of maternal outcomes from an alcohol, tobacco, and other drug prevention program for mothers choosing an intervention versus being randomized

Self-determination theory and substantial research findings suggest that more desirable outcomes may occur when participants are able to choose their prevention or treatment interventions, as having a choice may lead to greater motivation and feelings of self-efficacy. The present study examined the influence of having a choice of family-based prevention programs for youth alcohol, tobacco, and other drug use on mothers' communication outcomes. Families (N = 496) were those with an 11- to 12-year-old enrolled in Kaiser Permanente medical centers at one of four locations. Results from multivariate repeated measures analyses supported the importance of having a choice for improved communication outcomes. As compared with families who were randomly assigned to a program, those allowed to choose showed improved tobacco-specific and peer pressure communication, with marginally improved alcohol communication. No differences were found between the groups for general communication. Results suggest that allowing mothers to participate in decisions about health-related interventions for their teens may lead to better outcomes.

Culture and context: buffering the relationship between stressful life events and risky behaviors in American Indian youth

The Sacred Mountain Youth Project was conducted to investigate risk and protective factors related to alcohol and drug use among American Indian youth. Findings indicated that stressful life events were positively associated with depressed mood, substance use, and risky behavior; cultural identity had no direct effects, but a secondary model showed that social support and protective family and peer influences were related to cultural identity. These findings suggest that the relationships between stressors and their negative sequelae are complex. Emphasis on protective processes that are culturally specific to American Indian youth may lead to effective alcohol and drug use prevention programs.

Epidemiologic Trends of Adolescent Use of Alcohol, Tobacco, and Other Drugs

This article provides an overview of drug and alcohol use and risk factors among American adolescents. Current trends indicate that tobacco, alcohol, and marijuana are the most frequently used substances among this age group. Further, the greatest risk factors for using these substances are being male, being White, being an older adolescent, engaging in sexual risk behaviors, having a family history of substance abuse, associating with peers who abuse substances, and lacking a sense of school commitment and connectedness. These findings underscore the need to involve communities, families, schools, and peer groups to effectively prevent and treat this problem.