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

Alcohol use in multiracial American youth compared with monoracial youth: A meta-analysis

BACKGROUND AND AIMS

Although multiracial people comprise the fastest growing population in the United States, multiracial youth are nearly invisible in alcohol research. This meta-analysis synthesized the youth alcohol literature to estimate the magnitude of difference in alcohol use as a function of multiracial status.

DESIGN AND MEASUREMENTS

Empirical studies reporting multiracial and monoracial comparisons in youth (aged 10-24 years) alcohol use were identified through a systematic literature search. A random-effects meta-analysis was conducted using 85 effect sizes extracted from 16 studies assessing life-time, past-year, past-month and binge alcohol use.

SETTING AND PARTICIPANTS

A total of n=1 555 635 youth were assessed in the United States.

FINDINGS

Multiracial youth are suggested to be more likely to endorse life-time alcohol use than Asian youth [number of studies (k) = 3; odds ratio (OR) = 1.81, 95% confidence interval (CI) = 1.01, 3.24; p = 0.04], with significant between-study heterogeneity (Q = 8.42; p < 0.001; I2  = 76%) in effect size comparisons. Multiracial youth are suggested to be more likely to endorse past-month alcohol use than Black (k = 6; OR = 1.54, 95% CI = 1.38, 1.71; p < 0.001) and Asian (k = 4; OR = 2.09, 95% CI = 1.52, 2.88; p < 0.001) youth, but less likely than White (k = 6; OR = 0.87, 95% CI = 0.84, 0.91; p < 0.001) youth, with significant between-study heterogeneity for Black youth (Q = 11.94; p = 0.03; I2  = 58%) in effect size comparisons. Lastly, multiracial youth are suggested to be more likely to endorse binge alcohol use than Black (k = 4; OR = 1.98, 95% CI = 1.62, 2.44; p < 0.001) and Asian (k = 4; OR = 2.82, 95% CI = 2.28, 3.48; p < 0.001) youth, but less likely than White (k = 5; OR = 0.75, 95% CI = 0.70, 0.81; p < 0.001) and American Indian/Alaska Native (k = 3; OR = 0.78, 95% CI = 0.71, 0.85; p < 0.001) youth, with significant between-study heterogeneity among Black (Q = 23.99; p < 0.001; I2  = 87%) and Asian (Q = 17.76; p < 0.001; I2  = 83%) youth in effect size comparisons.

CONCLUSIONS

In the United States, multiracial youth report distinct alcohol use patterns compared with monoracial youth and may be at elevated alcohol use risk compared with Black and Asian youth.

Talking Circle for Young Adults (TC4YA) Intervention: A Culturally Safe Research Exemplar

BACKGROUND

: As a result of the intergenerational trauma impact and experience, Native Americans continue to exhibit trauma related issues such as high rates of substance use. After leaving high school, the pressures and stress of continuing an education, finding work/employment, and the responsibilities related to family and tribal community obligations result in the Native American young adult being more vulnerable to substance use.

OBJECTIVE

The purpose of this paper is to report findings of the Talking Circle intervention impact on the outcome variables of Native-Reliance, substance use, stress, and behavioral health, depression, and cumulative trauma.

METHODS

Native-Reliance was the theoretical underpinning for the study demonstrating culturally safe research. A pre-test/post-test one-group design was utilized to examine how the Talking Circle intervention influenced the outcome variables. 75 Native American participants, ages 18-24 participated in the Talking Circle intervention sessions. Baseline pre-intervention measures were completed and were repeated at 6-month post-intervention.

RESULTS

At 6-month post-intervention, Native-Reliance significantly revealed an increase of 40.55 (t = 22.13, p < .001), sources of stress (SS) revealed a significant decline of 3.68 (t= -18.39, p < .001), behavioral health issues (BH) showed a significant decline of 3.63 (t = -15.36, p < .001), substance related issues (SR) showed a significant decline of 3.57 (t = -15.24, p < .001), depression (PHQ-9) showed a significant decline of 4.85 (t = -17.02, p < .001), and cumulative trauma revealed a significant decline of 2.77 (t= -13.39, p < .001).

CONCLUSIONS

The use of a culturally safe Talking Circle intervention evidenced a research approach that resulted in the positive impact on reducing substance use and increasing the well-being of young Native American young adults.

IMPACT STATEMENT

Culturally safer intervention environments are conducive to results in outcomes that are positive and effective.

Racial and Ethnic Differences in Cannabis Use and Cannabis Use Disorder: Implications for Researchers

PURPOSE

Heavy and prolonged use of cannabis is associated with several adverse health, legal and social consequences. Although cannabis use impacts all U.S. racial/ethnic groups, studies have revealed racial/ethnic disparities in the initiation, prevalence, prevention and treatment of cannabis use and Cannabis Use Disorder (CUD). This review provides an overview of recent studies on cannabis and CUD by race/ethnicity and a discussion of implications for cannabis researchers.

FINDINGS

The majority of studies focused on cannabis use and CUD among African American/Black individuals, with the smallest number of studies found among Native Hawaiians/Pacific Islanders. The limited number of studies highlight unique risk and protective factors for each racial/ethnic group, such as gender, mental health status, polysubstance use and cultural identity.

SUMMARY

Future cannabis studies should aim to provide a deeper foundational understanding of factors that promote the initiation, maintenance, prevention and treatment of cannabis use and CUD among racial/ethnic groups. Cannabis studies should be unique to each racial/ethnic group and move beyond racial comparisons.