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Dong L, Brown RA, Palimaru AI, D’Amico EJ, Dickerson DL, Klein DJ, Johnson CL, Troxel WM. Enhancing sleep health in urban American Indian/Alaska Native adolescents: Implications for culturally tailored interventions. J Adolesc 2024; 96:1316-1327. [PMID: 38757459 PMCID: PMC11303116 DOI: 10.1002/jad.12350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Urban American Indian/Alaska Native (AI/AN) adolescents are vulnerable to sleep and other health-related disparities due to numerous social drivers, including historical trauma and relocation to urban areas. This study aims to identify strategies to increase protective factors and culturally tailor sleep health interventions for this population. METHODS Using community-based participatory research, the NAYSHAW study conducted in-depth interviews with urban AI/AN adolescents aged 12-19 years to understand critical components needed for developing a culturally sensitive sleep health intervention. Data from two qualitative subsamples (N = 46) and parent surveys (N = 110) were analyzed, focusing on factors that affect sleep health behaviors, including parental involvement, technology, and traditional practices. RESULTS Key findings include the detrimental impact of electronics use at night and protective effects of traditional practices on sleep. Parental involvement in sleep routines varied by adolescent's age. Adolescents desired sleep health education in interactive formats, whereas parents preferred workshops and digital applications for sleep health strategies. Findings suggest that interventions need to address electronics use and should also be culturally tailored to address the unique experiences of urban AI/AN adolescents. CONCLUSIONS Results underscore the importance of utilizing community-based strategies to develop culturally tailored sleep interventions for underserved populations, specifically urban AI/AN adolescents. Integrating traditional practices with evidence-based sleep health strategies can provide a holistic approach to improving sleep and overall well-being. Parental education and involvement will be critical to the success of such interventions.
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Affiliation(s)
- Lu Dong
- RAND Corporation, Santa Monica, CA
| | | | | | | | - Daniel L. Dickerson
- UCLA Integrated Substance Abuse Programs (ISAP), Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
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Redvers N, Larson S, Rajpathy O, Olson D. American Indian and Alaska Native recruitment strategies for health-related randomized controlled trials: A scoping review. PLoS One 2024; 19:e0302562. [PMID: 38687762 PMCID: PMC11060564 DOI: 10.1371/journal.pone.0302562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Significant health disparities exist among American Indian and Alaska Natives (AI/ANs), yet AI/ANs are substantially underrepresented within health-related research, including randomized controlled trials (RCTs). Although research has previously charted representation inequities, there is however a gap in the literature documenting best practice for recruitment techniques of AI/ANs into RCTs. Therefore, the aim of this review was to systematically gather and analyze the published literature to identify common strategies for AI/AN participant recruitment for RCTs in the US. METHODS A scoping review methodology was engaged with a systematic search operationalized within relevant databases to February 19, 2022, with an additional updated search being carried out up until January 1, 2023: PubMed, Embase, Web of Science, PsycINFO, CINAHL, and Google Scholar. A two-stage article review process was engaged with double reviewers using Covidence review software. Content analysis was then carried out within the included articles by two reviewers using NVivo software to identify common categories within the data on the topic area. RESULTS Our review identified forty-one relevant articles with the main categories of recruitment strategies being: 1) recruitment methods for AI/ANs into RCTs (passive advertising recruitment approaches, individual-level recruitment approaches, relational methods of recruitment); 2) recruitment personnel used within RCTs; and, 3) relevant recruitment setting. The majority of the included studies used a culturally relevant intervention, as well as a community-involved approach to operationalizing the research. CONCLUSION Increasing AI/AN representation in RCTs is essential for generating evidence-based interventions that effectively address health disparities and improve health outcomes. Researchers and funding agencies should prioritize the engagement, inclusion, and leadership of AI/AN communities throughout the RCT research process. This includes early community involvement in study design, implementation of culturally tailored recruitment strategies, and dissemination of research findings in formats accessible to AI/AN communities.
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Affiliation(s)
- Nicole Redvers
- Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
- Department of Indigenous Health, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND, United States of America
| | - Sarah Larson
- Department of Indigenous Health, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND, United States of America
| | - Olivia Rajpathy
- Department of Population Health, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND, United States of America
| | - Devon Olson
- Library Resources, School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND, United States of America
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Guenzel N, Daisy Dai H, Dean L. Context of substance initiation among urban Native Americans: an exploratory retrospective case-control study. PeerJ 2023; 11:e16482. [PMID: 38034870 PMCID: PMC10688302 DOI: 10.7717/peerj.16482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Background Addiction is a significant problem among many Native American groups but has rarely been examined in urban populations. In particular, little is known about the context in which urban Native Americans first use substances. This study compares cases (people with a history of addiction) to controls (people without a history of addiction) on demographics, substance use history, context of first substance use, and polysubstance use. In addition, this appears to be the first study to overcome the lack of Native American professionals by employing and training lay community members to identify criteria of substance use disorders in survey participants. Employing community members helped foster trust that enabled the revelation of sensitive and often illegal activity. As a result, the investigators were able to recruit participants who likely would not have engaged with traditional researchers. Methods The trained Native American lay research assistants recruited community members and administered surveys. They first asked questions regarding the criteria for substance use disorders. Individuals who were determined to have met criteria for a substance use disorder in the past were classified as cases (n = 38) and those who never met such criteria were classified as controls (n = 42). They then asked demographic, substance use, and polysubstance use questions. Lastly, eight cases and eight controls were randomly selected for a second interview by a licensed drug and alcohol counselor (LDAC) who conducted a blinded assessment regarding the presence or absence of a history of a substance use disorder. Results Both groups reported a relatively young age of first substance use (age 16 years for cases and age 15 years for controls). Alcohol was the first substance most commonly used in both groups. Controls reported first benzodiazepine use at a younger age than cases but no other significant differences were found. Both groups reported first obtaining their first drug from family, friends, or at home (rather than a party, bar, or store). Most commonly, the location of their first use of drugs occurred at a friend's home, a party, a bar, or school rather than at their own home. Cases were marginally more likely to report that their first drug use occurred with a friend rather than with a family member when compared with controls. The majority of both groups reported that their first drug use occurred with other Native Americans rather than with non-Native Americans. Polysubstance use was common in both groups (43-45%). There were no significant differences between the groups regarding polysubstance use. The LDAC arrived at the same determination as the trained research assistants on all eight cases and eight controls.
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Affiliation(s)
- Nicholas Guenzel
- College of Nursing, University of Nebraska Medical Center, Lincoln, NE, United States of America
| | - Hongying Daisy Dai
- College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States of America
| | - Lyndsay Dean
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, United States of America
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Crouch MC, Venner KL, Wendt DC, Burlew AK, Baukol P, Funaro MC, Sorrell T, Haeny AM. Lessons learned and future directions: A scoping review of American Indian and Alaska Native participants in the National Drug Abuse Treatment Clinical Trials Network. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 153:209081. [PMID: 37230391 PMCID: PMC10529616 DOI: 10.1016/j.josat.2023.209081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/09/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023]
Abstract
INTRODUCTION American Indian and Alaska Native (AI/AN) populations are disproportionately affected by substance use disorders (SUDs) and related health disparities in contrast to other ethnoracial groups in the United States. Over the past 20 years, substantial resources have been allocated to the National Institute on Drug Abuse Clinical Trials Network (CTN) to disseminate and implement effective SUD treatments in communities. However, we know little about how these resources have benefitted AI/AN peoples with SUD who arguably experience the greatest burden of SUDs. This review aims to determine lessons learned about AI/AN substance use and treatment outcomes in the CTN and the role of racism and Tribal identity. METHOD We conducted a scoping review informed by the Joanna Briggs framework and PRISMA Extension for Scoping Reviews checklist and explanation. The study team conducted the search strategy within the CTN Dissemination Library and nine additional databases for articles published between 2000 and 2021. The review included studies if they reported results for AI/AN participants. Two reviewers determined study eligibility. RESULTS A systematic search yielded 13 empirical articles and six conceptual articles. Themes from the 13 empirical articles included: (1) Tribal Identity: Race, Culture, and Discrimination; (2) Treatment Engagement: Access and Retention; (3) Comorbid Conditions; (4) HIV/Risky Sexual Behaviors; and (5) Dissemination. The most salient theme was Tribal Identity: Race, Culture, and Discrimination, which was present in all articles that included a primary AI/AN sample (k = 8). Themes assessed but not identified for AI/AN peoples were Harm Reduction, Measurement Equivalence, Pharmacotherapy, and Substance Use Outcomes. The conceptual contributions used AI/AN CTN studies as exemplars of community-based and Tribal participatory research (CBPR/TPR). CONCLUSION CTN studies conducted with AI/AN communities demonstrate culturally congruent methods, including CBPR/TPR strategies; consideration/assessment of cultural identity, racism, and discrimination; and CBPR/TPR informed dissemination plans. Although important efforts are underway to increase AI/AN participation in the CTN, future research would benefit from strategies to increase participation of this population. Such strategies include reporting AI/AN subgroup data; addressing issues of cultural identity and experiences of racism; and adopting an overall effort for research aimed at understanding barriers to treatment access, engagement, utilization, retention, and outcomes for both treatment and research disparities for AI/AN populations.
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Affiliation(s)
- Maria C Crouch
- Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States.
| | - Kamilla L Venner
- University of New Mexico, 1 University of New Mexico, MSC03 2220, Albuquerque, NM 87131-0001, United States
| | - Dennis C Wendt
- McGill University, 3700 McTavish St., Room 614, Montreal, QC H3A 1Y2, Canada
| | - Ann Kathleen Burlew
- University of Cincinnati, 2600 Clifton Ave., Cincinnati, OH 45220, United States
| | - Paulette Baukol
- Berman Center for Outcomes & Clinical Research, 701 Park Ave., Suite PP7.700, Minneapolis, MN 55415, United States
| | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, 333 Cedar St, New Haven, CT 06510, United States
| | - Tanya Sorrell
- Rush University Medical Center, 1645 W Jackson Blvd, Westgate Building, Suite 600, Chicago, IL 60612, United States
| | - Angela M Haeny
- Yale University School of Medicine, 333 Cedar St, New Haven, CT 06510, United States
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Komro KA, D'Amico EJ, Dickerson DL, Skinner JR, Johnson CL, Kominsky TK, Etz K. Culturally Responsive Opioid and Other Drug Prevention for American Indian/Alaska Native People: a Comparison of Reservation- and Urban-Based Approaches. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:88-98. [PMID: 35750937 PMCID: PMC9244356 DOI: 10.1007/s11121-022-01396-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2022] [Indexed: 11/24/2022]
Abstract
There are few substance use treatment and prevention programs for AI/AN people that integrate culturally based practices with evidence-based treatment and prevention. The National Institutes of Health's (NIH's) Helping to End Addiction Long-term (HEAL) Prevention Cooperative supports two projects focused on AI/AN populations. One focuses on youth ages 15 to 20 years living within the Cherokee Nation reservation, a multicultural rural area in northeastern Oklahoma, and the second focuses on emerging adults ages 18 to 25 years living in diverse urban areas. We provide a brief overview of the two prevention trials and a case comparison across approaches using the framework of promising practices for intervention science with Indigenous communities (Whitesell et al., 2020) related to (1) integration of Indigenous and academic perspectives to respond to community needs, (2) community partnership and engagement, (3) alignment with Indigenous cultural values and practices, (4) capacity building and empowerment, (5) implementation within complex cultural contexts, and (6) tribal oversight. Overall, these two projects highlight the importance of long-standing relationships with community partners, engaging the community at all levels to ensure that programming is culturally and developmentally appropriate, and having tribal and elder oversight. These practices are key to establishing trust and building confidence in research in these communities and ensuring that research can benefit AI/AN people. These studies showcase how strong partnerships can advance health and support the conduct of rigorous science to help pinpoint optimal health solutions by identifying efficacious, culturally grounded intervention strategies. Although the sovereign status of tribes demands this type of partnership, this research serves as a model for all community research that has a goal of improving health.
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Affiliation(s)
- Kelli A Komro
- Department of Behavioral, Social, and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | | | - Daniel L Dickerson
- Integrated Substance Abuse Programs (ISAP), University of California Los Angeles, Los Angeles, CA, USA
| | | | | | | | - Kathy Etz
- Epidemiology Research Branch, National Institute On Drug Abuse, North Bethesda, USA
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Pomerville A, Wilbur RE, Pham TV, King CA, Gone JP. Behavioral health services in Urban American Indian Health Programs: Results from six site visits. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2618-2634. [PMID: 36976752 DOI: 10.1002/jcop.23035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/02/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
This study explores behavioral health services for American Indians and Alaska Natives (AIANs) at six Urban Indian Health Programs (UIHPs). Interviews and focus groups with clinicians and staff inquired about behavioral health treatment available, service needs, client population, and financial and staffing challenges. Resulting site profiles were created based on focused coding and integrative memoing of site visit field notes and respondent transcripts. These six UIHPs evidenced diversity across multiple facets of service delivery even as they were united in their missions to provide accessible and effective behavioral health treatment to urban AIAN clients. Primary challenges to service provision included heterogenous client populations, low insurance coverage, limited provider knowledge, lack of resources, and incorporation of traditional healing. Collaborative research with UIHPs harbors the potential to recognize challenges, identify solutions, and share best practices across this crucial network of health care sites for improving urban AIAN well-being.
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Affiliation(s)
- Andrew Pomerville
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rachel E Wilbur
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Tony V Pham
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Cheryl A King
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Joseph P Gone
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Anthropology, Harvard University, Cambridge, Massachusetts, USA
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Chase-Begay DM, Peterson JC, Liddell J, Belcourt A. Traditional Ceremonial Practices as a Strategy to Reduce Problem Substance Use in American Indian Communities: A Systematic Review. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:408-419. [PMID: 37229620 PMCID: PMC10280199 DOI: 10.1089/jicm.2022.0655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Objective: This systematic review assessed the feasibility of American Indian traditional ceremonial practices (TCPs) to address problem substance use in both reservation and urban settings. Methods: Between September 24, 2021, and January 14, 2022, culturally specific review protocols were applied to articles retrieved from over 160 electronic databases-including PubMed, Global Health, Global Health Archive, CINAHL Complete, PsychInfo, Web of Science, Health and Wellness (Gale), Sage Online Journals, and ScienceDirect. Results: A total of 10 studies met the criteria for inclusion in the review. Studies were conducted with both urban (n = 7) and reservation (n = 3) American Indian and Alaska Native (AIAN) populations. The most common TCP activities reported were drumming (n = 9), sweat lodge (n = 7), and talking circles (n = 6). All 10 studies reported some type of quantitative data showing a reduction of substance use associated with TCP interventions or activities. Conclusions: The current status of the literature is emerging and does not allow for meta-analysis of existing studies. However, the existing literature does indicate promise for the use of TCPs to address problem substance use in AIAN communities in a way that is effective and also culturally congruent.
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Affiliation(s)
- Damian M. Chase-Begay
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | | | - Jessica Liddell
- School of Social Work, University of Montana, Missoula, MT, USA
| | - Annie Belcourt
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
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Franco Corso SJ, O'Malley K, Subaiya S, Mayall D, Dakwar E. The role of non-ordinary states of consciousness occasioned by mind-body practices in mental health illness. J Affect Disord 2023; 335:166-176. [PMID: 37150220 DOI: 10.1016/j.jad.2023.04.116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 04/13/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Research with hallucinogens suggests that non-ordinary states of consciousness (NOSCs), particularly mystical-type experiences, predict improvements in various affective disorders and substance use disorders (SUDs). Little is known, however, about the therapeutic potential of NOSCs induced by mind-body practices such as meditation, yoga and breathwork. METHODS We conducted a literature review in online databases (PubMed, Scopus, Google Scholar) and preprint databases (SSRN, bioRxiv) to identify studies of NOSCs induced by mind-body practices and their effects in affective disorders and SUDs. RESULTS A wide variety of mind-body practices involving physical movement (i.e., shamanic drumming, yoga) and hyper-focused immersive mental experiences (i.e., meditation, breathwork) have been reported in the literature. Preliminary evidence, mostly from qualitative studies and open label studies, suggest that mind-body practices produce NOSCs. Such experiences have been associated with short-term reduced levels of anxiety and depression, increased motivation to quit addictive behaviors, and enhanced self-awareness and spiritual well-being. LIMITATIONS Findings are limited by the scarcity of literature in this field. Further rigorous and methodologically sound empirical research is needed, including comparative studies of NOSCs occasioned by different methods. CONCLUSIONS Mind-body practices may represent a promising approach for treating mental health disorders. The NOSCs induced by such practices may lead to beneficial shifts in perceptions, values, beliefs, and behaviors. Given the challenges with hallucinogen-based therapies, mind-body practices may represent a more accessible and acceptable way of eliciting potentially helpful NOSCs in clinical practice.
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Affiliation(s)
- Silvia J Franco Corso
- Department of Psychiatry, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, United States of America; Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America.
| | - Kate O'Malley
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Saleena Subaiya
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Danielle Mayall
- Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
| | - Elias Dakwar
- Department of Psychiatry, Columbia University Vangelos College of Physicians and Surgeons, New York, NY, United States of America; Division on Substance Use, New York State Psychiatric Institute and Department of Psychiatry, New York, NY, United States of America
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Dickerson DL, D'Amico EJ, Palimaru A, Brown R, Kennedy D, Johnson CL, Schweigman K. Traditions and Connections for Urban Native Americans (TACUNA): Utilizing community-based input to develop an opioid prevention intervention for urban American Indian/Alaska Native emerging adults. J Subst Abuse Treat 2022; 139:108764. [PMID: 35450751 PMCID: PMC9187599 DOI: 10.1016/j.jsat.2022.108764] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 01/26/2022] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Although approximately 70% of American Indian/Alaska Native (AI/AN) people reside in urban areas, very few opioid prevention interventions exist for urban AI/AN emerging adults. The study team conducted this study to develop Traditions and Connections for Urban Native Americans (TACUNA), a new opioid prevention intervention for urban AI/AN emerging adults ages 18-25. TACUNA comprises three 2-hour virtual workshops. METHODS We conducted thirteen focus groups in three urban communities in northern, central, and southern California (six with urban AI/AN emerging adults ages 18-25 [n = 32], four with parents [n = 26], and three with providers [n = 33]) to identify relevant intervention domains. We then incorporated the results of a rapid analysis of the focus groups to develop intervention workshops followed by a pilot test (n = 15) to further refine the intervention and assess feasibility. RESULTS Four major domains emerged from focus groups: 1) historical trauma/cultural identity, 2) AI/AN traditional practices, 3) social networks, and 4) substance use. We incorporated all feedback relating to each theme to enhance content of the TACUNA intervention. Pilot test participants felt that TACUNA content was interesting, addressed their issues and concerns as urban AI/AN emerging adults, and believed that the program could help them to establish cultural and social connections to live healthier lives. CONCLUSIONS Research activities demonstrate how a community-informed and culturally grounded opioid prevention intervention can be developed for urban AI/AN emerging adults. Addressing issues and challenges with culturally and developmentally relevant intervention content can help to build resilience and hopefully decrease opioid use among this underserved population.
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Affiliation(s)
- Daniel L Dickerson
- University of California, Los Angeles, Integrated Substance Abuse Programs (ISAP), 17707 Santa Monica Blvd., #200, Los Angeles, CA 90025, USA.
| | | | - Alina Palimaru
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA.
| | - Ryan Brown
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA.
| | - David Kennedy
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90401, USA.
| | - Carrie L Johnson
- Sacred Path Indigenous Wellness Center, Los Angeles, CA 90017, USA
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Soto C, West AE, Ramos GG, Unger JB. Substance and Behavioral Addictions among American Indian and Alaska Native Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2974. [PMID: 35270667 PMCID: PMC8910676 DOI: 10.3390/ijerph19052974] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 02/22/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE This paper examines substance and behavioral addictions among American Indian and Alaska Natives (AIAN) to identify the structural and psychosocial risk and cultural protective factors that are associated with substance use and behavioral addictions. METHODS Five databases were used to search for peer reviewed articles through December 2021 that examined substance and behavioral addictions among AIANs. RESULTS The literature search identified 69 articles. Numerous risk factors (i.e., life stressors, severe trauma, family history of alcohol use) and protective factors (i.e., ethnic identity, family support) influence multiple substance (i.e., commercial tobacco, alcohol, opioid, stimulants) and behavioral (e.g., gambling) addictions. CONCLUSIONS There is a dearth of research on behavioral addictions among AIANs. Unique risk factors in AIAN communities such as historical trauma and socioeconomic challenges have interfered with traditional cultural resilience factors and have increased the risk of behavioral addictions. Future research on resilience factors and effective prevention and treatment interventions could help AIANs avoid behavioral addictions.
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Affiliation(s)
- Claradina Soto
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (G.G.R.); (J.B.U.)
| | - Amy E. West
- Department of Pediatrics, Keck School of Medicine, Children’s Hospital Los Angeles, University of Southern California, Los Angeles, CA 90027, USA;
| | - Guadalupe G. Ramos
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (G.G.R.); (J.B.U.)
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA; (G.G.R.); (J.B.U.)
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