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Walker D, Pearson C, Day A, Bedard-Gilligan M, Saluskin K, Huh D, Kaysen D. A Community Engaged Approach in Adapting Motivational Interviewing and Skills Training for Native Americans With Experiences of Substance Misuse. Am J Health Promot 2023; 37:796-806. [PMID: 36869715 PMCID: PMC10311937 DOI: 10.1177/08901171231161467] [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] [Indexed: 03/05/2023]
Abstract
OBJECTIVE American Indian and Alaskan Natives (AIAN) are regenerating cultural knowledge and practices to adapt westernized evidence-based interventions to address health concerns such as substance use. This study describes the process of selecting, adapting, and implementing motivational interviewing plus cognitive behavior therapy (motivational interviewing + Skills Training; MIST) for use in a combined substance use intervention with a rural, Northwest tribal community. METHODS An established community and academic partnership worked together to make culturally mindful changes to MIST. The partnership incorporated community leaders/Elders (n = 7), providers (n = 9), and participants (n = 50) to implement an iterative process of adapting and implementing the adapted form of MIST. RESULTS Key adaptations included presenting concepts grounded in tribal values, providing examples from the community perspective, and incorporating cultural customs and traditions. Overall, the MIST adaptation was favorably received by participants, and the adaptation appeared feasible. CONCLUSIONS Adapted MIST appeared to be an acceptable intervention for this Native American community. Future research should evaluate the interventions efficacy in reducing substance use among this and other Native American communities. Future clinical research should consider strategies outlined in this adaptation as a potential process for working with Native American communities to implement culturally appropriate interventions.
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Affiliation(s)
- Denise Walker
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Cynthia Pearson
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Angelique Day
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Michele Bedard-Gilligan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | | | - David Huh
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University, CA, USA
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Woods C, Kim B, Guo K, Nyguen T, Taplayan S, Aronowitz T. Factors That Influence Substance Use Among American Indian/Alaskan Native Youth: A Systematic Mixed Studies Review. J Am Psychiatr Nurses Assoc 2022; 28:37-57. [PMID: 34396829 DOI: 10.1177/10783903211038050] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The American Indian/Alaskan Native (AI/AN) mortality rate from illicit drug use was 22.7%, double that of the general population between 2007 and 2009. Fifteen percent of AI/AN youth reported receiving treatment for substance use compared with 10% of non-AI/AN peers. OBJECTIVE The purpose was to explore the factors that influence substance use among AI/AN youth. METHOD We performed a systematic review using a results-based convergent synthesis design. Eight electronic databases were searched for articles published between 2014 and 2019 using the search terms "Native American youth," "Native American adolescent," "Native Youth," "substance use," "substance misuse," and "substance abuse." The Mixed Methods Appraisal Tool was used to appraise the studies. RESULTS Forty-seven studies met the inclusion criteria (44 quantitative, one qualitative, and two mixed-methods studies). The results were organized using the ecological systems model and included evaluation of both protective and risk factors related to AI/AN youth substance use. Three system levels were found to influence substance use: individual, micro- and macrosystems. The individual systems-level coping mechanisms played a key role in whether AI/AN youth initiated substance use. Family, school, and peer factors influence the microsystem level. At the macrosystem level, community environmental factors were influential. CONCLUSION The major factor linking all the systems was the influence of a connected relationship with a prosocial adult who instilled future aspirations and a positive cultural identity. Findings of this systematic mixed studies review will assist in intervention development for AI/AN youth to prevent substance misuse.
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Affiliation(s)
- Cedric Woods
- Cedric Woods, PhD, University of Massachusetts Boston, Boston, MA, USA
| | - BoRam Kim
- BoRam Kim, BSN, RN, University of Massachusetts, Boston, MA, USA
| | - Kristine Guo
- Kristine Guo, University of Massachusetts, Boston, MA, USA
| | - Tuyet Nyguen
- Tuyet Nugyen, University of Massachusetts Boston, MA, USA
| | - Sarin Taplayan
- Sarin Tapalyan, BSN, University of Massachusetts, Boston, MA, USA
| | - Teri Aronowitz
- Teri Aronowitz, PhD, APRN, FNP-BC, FAAN, University of Massachusetts Boston, Boston, MA, USA
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Schick MR, Nalven T, Thomas ED, Weiss NH, Spillane NS. Depression and alcohol use in American Indian adolescents: The influence of family factors. Alcohol Clin Exp Res 2022; 46:141-151. [PMID: 35076972 PMCID: PMC8988920 DOI: 10.1111/acer.14748] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND Rates of both depression and alcohol use are disproportionately higher among American Indian (AI) adolescents than adolescents in the general population. The co-occurrence of depression and alcohol use is common and clinically relevant given their reciprocal negative influences on outcomes. Family factors may be especially relevant because they could have a buffering effect on this relationship due to the importance of kinship and community in AI communities. The current study examines the roles of family warmth and parental monitoring in the association between depressive symptoms and alcohol use in a large, nationally representative sample of AI adolescents. METHODS Data were collected from 3498 AI 7th to 12th graders (47.8% female) residing on or near a reservation during the period 2009 to 2013. Participants reported on their depressive symptoms, family factors, and alcohol use. RESULTS There was a small, but statistically significant positive association between depressive symptoms and alcohol use (r = 0.11, p < 0.001). Greater depressive symptoms were associated with significantly less perceived family warmth (β = -0.09, 95% CI [-0.13, -0.06]), which was associated with significantly greater alcohol use (β = -0.39, 95% CI [-0.55, -0.23]). Family warmth significantly accounted for the association between depressive symptoms and alcohol use at high (β = 0.04, SE = 0.02, 95% CI [0.004, 0.09]), but not low, levels of parental monitoring (β = 0.02, SE = 0.02, 95% CI [-0.002, 0.06]). CONCLUSIONS Results of the present study suggest that developing culturally sensitive prevention and treatment approaches focusing on increasing both family warmth and parental monitoring are important to address the co-occurrence of depression and alcohol misuse among AI adolescents.
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Affiliation(s)
- Melissa R. Schick
- Department of Psychology University of Rhode Island Kingston Rhode Island USA
| | - Tessa Nalven
- Department of Psychology University of Rhode Island Kingston Rhode Island USA
| | - Emmanuel D. Thomas
- Department of Psychology University of Rhode Island Kingston Rhode Island USA
| | - Nicole H. Weiss
- Department of Psychology University of Rhode Island Kingston Rhode Island USA
| | - Nichea S. Spillane
- Department of Psychology University of Rhode Island Kingston Rhode Island USA
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Ning K, Gondek D, Patalay P, Ploubidis GB. The association between early life mental health and alcohol use behaviours in adulthood: A systematic review. PLoS One 2020; 15:e0228667. [PMID: 32069303 PMCID: PMC7028290 DOI: 10.1371/journal.pone.0228667] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 01/20/2020] [Indexed: 02/07/2023] Open
Abstract
This systematic review aims to summarise current evidence on the association between early life mental health and alcohol use behaviours in adulthood. Peer-reviewed publications were located by searching EMBASE, Medline, PsycINFO, and the ISI Web of Science up to 31 October 2018. Prospective longitudinal studies reporting associations between externalising problems (EXT), internalising problems (INT), depression, anxiety before age 18, and alcohol use behaviours (alcohol consumption, heavy/problematic drinking, alcohol use disorder) after age 18 were included. After screening 17259 articles, 36 articles met the inclusion criteria. Information extracted included strength of associations, age when mental health and alcohol use behaviours were measured, sex differences in the association, and other sample characteristics. 103 tests in 23 articles were identified on the externalising domain and 135 tests in 26 articles on the internalising domain. 37 out of 103 tests reported positive associations between EXT and alcohol use behaviours. The likelihood of observing positive associations was higher for more severe alcohol use outcomes, but this trend disappeared among high-quality studies. Findings on associations between internalising domain and alcohol use varied across their subtypes. INT tended to be negatively associated with alcohol consumption but positively associated with more severe outcomes (heavy/problematic drinking, alcohol use disorder). Depression tended to be positively associated with alcohol outcomes, while no clear association between anxiety and alcohol outcomes was evident. Variation of the association across developmental timing, sex, culture, historical period was explored where appropriate. Great heterogeneity in the current literature calls for greater attention to view the relationship developmentally.
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Affiliation(s)
- Ke Ning
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
| | - Dawid Gondek
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
| | - Praveetha Patalay
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
| | - George B. Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, University College of London, London, The United Kingdom
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Swaim RC, Stanley LR. Predictors of Substance Use Latent Classes Among American Indian Youth Attending Schools On or Near Reservations. Am J Addict 2020; 29:27-34. [PMID: 31041821 PMCID: PMC7053646 DOI: 10.1111/ajad.12894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/28/2019] [Accepted: 04/13/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Identical latent classes of substance use for 7 to 8 grade and 9 to 12 grade American Indian (AI) youth living on or near reservations suggest that patterns of substance use are established early among these youth. This study examines relationships of substance-related factors to latent class membership and whether these relationships differ by grade group. METHODS In-school surveys were administered to 1503 7 to 8 grade and 1995 9 to 12 grade students from 46 schools on or near reservations during the 2009/2010 to 2012/2013 school years. Four-class latent class models of substance use were specified and five classes of substance-related factors (peers, substance availability, perceived harm, family, early initiation), plus grade level and gender, were evaluated as predictors. RESULTS For 7 to 8 grade students, substance-related factors differentiated nonusers from users, while for 9 to 12 graders, these factors also differentiated types of users. Early initiation and peer factors were strongly related to class membership, while other factors were less strongly related. DISCUSSION AND CONCLUSIONS Early initiation of alcohol or marijuana is strongly related to being in a substance-using class for AI youth. Because these youth tend to initiate use earlier that other US youth, prevention resources should be targeted to reaching them and their families before age 12. SCIENTIFIC SIGNIFICANCE Predictors of latent classes of substance use were identified for reservation-based AI youth. While the classes were identical for 7 to 8 grade and 9 to 12 grade youth, predictors varied across grade group, which may inform how best to develop prevention efforts unique to middle and high school AI youth.
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Affiliation(s)
- Randall C Swaim
- Department of Psychology, Colorado State University, Fort Collins, Colorado
| | - Linda R Stanley
- Department of Psychology, Colorado State University, Fort Collins, Colorado
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Dyer ML, Easey KE, Heron J, Hickman M, Munafò MR. Associations of child and adolescent anxiety with later alcohol use and disorders: a systematic review and meta-analysis of prospective cohort studies. Addiction 2019; 114:968-982. [PMID: 30891835 PMCID: PMC6563455 DOI: 10.1111/add.14575] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/12/2018] [Accepted: 01/30/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Despite a wealth of literature, the relationship between anxiety and alcohol use remains unclear. We examined whether (a) child and adolescent anxiety is positively or negatively associated with later alcohol use and disorders and (b) study characteristics explain inconsistencies in findings. DESIGN AND SETTING We conducted a systematic review of 51 prospective cohort studies from 11 countries. Three studies contributed to a meta-analysis. We searched PubMed, Scopus, Web of Science and PsycINFO databases, and studies were included if they met the following criteria: English language publication, human participants, anxiety exposure (predictor variable) in childhood or adolescence and alcohol outcome at least 6 months later. PARTICIPANTS Study sample sizes ranged from 110 to 11 157 participants. Anxiety exposure ages ranged from 3 to 24 years, and alcohol outcome ages ranged from 11 to 42 years. MEASUREMENTS Ninety-seven associations across 51 studies were categorized by anxiety exposure (generalized anxiety disorder, internalizing disorders, miscellaneous anxiety, obsessive compulsive disorder, panic disorder, separation anxiety disorder, social anxiety disorder and specific phobias) and alcohol use outcome (drinking frequency/quantity, binge drinking and alcohol use disorders). FINDINGS The narrative synthesis revealed some evidence for a positive association between anxiety and later alcohol use disorders. Associations of anxiety with later drinking frequency/quantity and binge drinking were inconsistent. Type and developmental period of anxiety, follow-up duration, sample size and confounders considered did not appear to explain the discrepant findings. The meta-analysis also showed no clear evidence of a relationship between generalized anxiety disorder and later alcohol use disorder (odds ratio = 0.94, 95% confidence interval = 0.47-1.87). CONCLUSIONS Evidence to date is suggestive, but far from conclusive of a positive association between anxiety during childhood and adolescence and subsequent alcohol use disorder.
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Affiliation(s)
- Maddy L Dyer
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Kayleigh E Easey
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
| | - Marcus R Munafò
- UK Centre for Tobacco and Alcohol Studies, School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), University of Bristol, Bristol, UK
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Swaim RC, Stanley LR. Effects of Family Conflict and Anger on Alcohol Use Among American Indian Students: Mediating Effects of Outcome Expectancies. J Stud Alcohol Drugs 2018; 79:102-110. [PMID: 29227238 PMCID: PMC9798485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Identification of etiologic mechanisms underlying alcohol use among American Indian adolescents is essential because of higher rates of use and earlier initiation. One path links positive outcome expectancies to increased use for reduction of negative affect. This study estimates relationships between two aspects of distress among American Indian high school students-family conflict and anger-and alcohol involvement, and it investigates whether outcome expectancies serve as a mediator between these facets of distress and alcohol use. METHOD Structural equation modeling evaluated study hypotheses among 975 female and 936 male American Indian 9th- through 12th-grade students residing on or near reservations. Students were from 17 high schools recruited across six geographic regions where American Indians on reservations reside. Separate models were assessed for male and female students. RESULTS Outcome expectancies mediated the relationship between both anger and family conflict for female students, but only for anger among male students. Full mediation was found for all significant effects. CONCLUSIONS For female American Indian high school students, anger and family conflict operate in large degree through outcome expectancies for alcohol use. A similar effect is found for male students for anger.
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Affiliation(s)
- Randall C. Swaim
- Tri-Ethnic Center for Prevention Research, Department of Psychology, College of Natural Sciences, Colorado State University, Fort Collins, Colorado,Correspondence may be sent to Randall C. Swaim at the Tri-Ethnic Center for prevention Research, Department of psychology, Colorado State University, 106 Sage Hall, Fort Collins, CO 80523-1879, or via email at:
| | - Linda R. Stanley
- Tri-Ethnic Center for Prevention Research, Department of Psychology, College of Natural Sciences, Colorado State University, Fort Collins, Colorado
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Swaim RC, Stanley LR. Multivariate family factors in lifetime and current marijuana use among American Indian and white adolescents residing on or near reservations. Drug Alcohol Depend 2016; 169:92-100. [PMID: 27810659 PMCID: PMC5140847 DOI: 10.1016/j.drugalcdep.2016.09.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 09/29/2016] [Accepted: 09/30/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND Rates of marijuana use are consistently high among reservation-based American Indian adolescents. The roles of family are unique in this ethnic group and can serve as sources of both risk and protection for substance use. PURPOSE To assess the relationships between distal and proximal family factors and lifetime and current marijuana use among American Indian and white middle and high school students who attend the same schools on or near reservations. METHODS In-school surveys were administered to 3380 American Indian and 1562 white students from 35 middle schools and 17 high schools regarding levels of marijuana use and family characteristics. Three logistic regression models (Control, Control+Distal; Control+Distral+Proximal) estimated effects of multiple family variables on lifetime and current marijuana use. RESULTS Strong effects were found for family structure, parental monitoring, family conflict, and family sanctions against marijuana use. Weaker effects were found for family participation in school events, and no relationship was found for family communication about marijuana. Anumber of similar results were found across ethnicity and middle and high school students. CONCLUSIONS Family variables exert strong and largely consistent effects across reservation-based American Indian and white youth on lifetime and current marijuana use. Interventions that include a broad range of targeted family components may serve to both limit uptake and forestall increases in adolescent marijuana use in these two groups.
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Affiliation(s)
- Randall C Swaim
- Department of Psychology, Colorado State University, Fort Collins, CO, USA.
| | - Linda R Stanley
- Department of Psychology, Colorado State University, Fort Collins, CO, USA.
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