Abstract Objectives To investigate growth in problem drinking and monthly marijuana use among North American Indigenous adolescents from the upper Midwest and Canada. Methods Panel data from a ...community-based participatory research project includes responses from 619 adolescents residing on or near 7 different reservations/reserves. All respondents were members of the same Indigenous cultural group. Results Rates of problem drinking and monthly marijuana use increased steadily across the adolescent years, with fastest growth occurring in early adolescence (before age 15). In general, female participants reported higher rates of substance use prior to age 15; however, male reports of use surpassed those of females in later adolescence. Conclusions Results of this study highlight the importance of early adolescent substance use prevention efforts and the possible utility of gender responsive programming.
North American Indigenous communities experience disproportionately high rates of substance use, abuse, and dependence and their accompanying consequences. This study uses group‐based trajectory ...modeling of past‐year substance use (alcohol, marijuana, and cigarettes) with a longitudinal sample of Indigenous adolescents from the northern Midwest and Canada (spanning ages 10–18 years). The early‐onset trajectory (36.3%) had more adverse psychosocial difficulties at baseline than the mid‐onset group (38.3%); both trajectories were associated with several negative outcomes at the end of the study. The late‐onset trajectory (25.3%) did not initiate substance use until later adolescence and had far better outcomes at the last wave of the study. Timing of onset matters. Prevention efforts should begin in late childhood and continue through mid‐adolescence.
We used a novel measure of cultural efficacy to examine empirical pathways between enculturation, efficacy, and two wellbeing outcomes. Cultural factors are not consistently linked to better ...wellbeing in the academic literature despite widespread understanding of these processes in Indigenous communities. Healing pathways is a community‐based participatory study with eight reservations/reserves in the upper Midwest and Canada. This study uses data collected in 2017–2018 (n = 453, 58.1% women, mean age = 26.3 years) and structural equation modeling to test the relationships between enculturation, cultural efficacy, and mental health. The direct effect of enculturation on anxiety was positive. The indirect effect of enculturation via cultural efficacy was negatively associated with anxiety and positively associated with positive mental health. Cultural efficacy is an important linking variable through which the protective effects of culture manifest. The complex nature of culture must be met with innovative measures and deep understanding of Indigenous peoples to fully capture the protective role of culture.
Highlights
Empirical evidence often fails to reflect the innate wisdom within Indigenous communities.
Cultural efficacy considers the colonial impact on one's personal agency to engage culturally.
Cultural efficacy is important to consider when promoting Indigenous mental wellbeing.
Abstract The proportion of youth who abstain from alcohol use decreases during adolescence but little attention has focused on factors associated with abstinence. No research has examined this ...question for Indigenous youth, many of whom live in communities experiencing high rates of alcohol-related health problems. Using data from a longitudinal study of Indigenous youth (n = 649, ages 10–17 years) in the U.S. and Canada, the current study investigates factors associated promoting or decreasing abstaining from alcohol use. Results from generalized linear growth models demonstrate that abstinence declines significantly during adolescence. In concurrent models, caretaker monitoring and school adjustment increased the odds of abstaining, and frequency of smoking cigarettes and number of best friends who drink decreased the odds. In lagged analysis, only school adjustment, smoking, and peer drinking remained significant. Time-stable characteristics moderated several time-varying associations. This study has important implications for programs aimed at encouraging alcohol abstinence.
Empirical efforts to identify the predictors of drinking behavior among North American Indigenous adolescents are relatively limited. Using longitudinal data, this study considers perceived ...discrimination, positive drinker prototypes, and peer drinking behavior as risk factors for the onset of alcohol use and development of an alcohol use disorder among 674 Indigenous adolescents as they progressed from early to late adolescence (M age at baseline = 11.11, SD = 0.83). Results showed that positive drinker prototypes and associations with peers who drink increased the risk for the onset of drinking, while perceived discrimination and associations with peers who drink increased the risk for the development of an alcohol use disorder. The theoretical and practical implications of our results are discussed.
We examined the longitudinal measurement properties and predictive utility of the Center for Epidemiologic Studies Depression Scale (CES-D) from early to late adolescence among a sample of North ...American Indigenous youths. Participants were 632 North American Indigenous adolescents (n = 632; 50.3% girls; M age at baseline = 11.11 years) participating in an 8-year, 8-wave longitudinal study. Via in-person interviews, participants completed the CES-D at Waves 1, 3, 5, and 7, and the major depressive disorder (MDD) module of the Diagnostic Interview Schedule for Children at Waves 1, 4, 6, and 8. Confirmatory factor analyses indicated that responses to the CES-D were similarly explained by 2-, 3-, and 4-factor models, as well as a 1-factor model with correlations between the error variances for the positively worded items. Longitudinal measurement equivalence analyses indicated full structural (i.e., factor structure), metric (i.e., factor loadings), and scalar (i.e., observed item intercepts) equivalence for each factor structure. Substantive analyses showed that the CES-D was significantly associated with MDD both concurrently and prospectively, although these effects were smaller than might be expected. Finally, the CES-D negative affect and somatic complaints subscales were the strongest and most consistent predictors of MDD. Among our sample of North American Indigenous youths, the measurement properties of the CES-D were stable from early to late adolescence. Moreover, somatic difficulties and depressed affect were the strongest predictors of MDD.
Background. Medication adherence is negatively related to both diabetes distress (DD) and depressive symptoms (DS). Past research suggests gender differences in adherence, DD, and DS. A gap exists in ...determining if gender differences in adherence are mediated by DD and DS, or if gender moderates differences in adherence by DD/DS. Aims. This study investigated the relationship between gender, DD, DS, and medication adherence and tested for mediating and moderating effects on medication adherence among American Indian adults with type 2 diabetes. Method. The Maawaji idi-oog mino-ayaawin (Gathering for Health) study was a community-based participatory research collaboration with five American Indian tribes. Participants, randomly recruited from clinic records, shared information during computer-assisted personal interviews. This study includes the 166 participants who reported using medications to treat their diabetes. The relationship between gender, DD, DS, and medication adherence are explored. Possible mediating and moderating effects on medication were tested using regression and path analysis. Results. Females had higher levels of DD and DS and lower levels of medication adherence. Higher levels of DD and DS were both associated with lower medication adherence. No evidence was found that gender moderates the relationship between DD or DS and medication adherence. Instead, DD and DS mediated the relationship between gender and medication adherence. Conclusions. Medication adherence differences in male and female patients may be attributable to DD and DS. The present research highlights both DD and DS as targets for clinicians and researchers alike.
American Indian/Alaska Native people experience the highest age-adjusted prevalence of type 2 diabetes of any racial group in the United States, as well as high rates of related health problems. ...Chronic stressors such as perceived discrimination are important contributors to these persistent health disparities. The current study used structural equation modeling to examine the relationships between racial microaggressions, diabetes distress, and self-care behaviors (diet and exercise) in a sample of 192 American Indians with type 2 diabetes from the northern United States. We found that microaggressions was positively associated with diabetes distress and that microaggressions had an indirect link to self-care via diabetes distress. Diabetes distress is an important mechanism linking microaggressions to self-care behaviors, which are critical to successful disease management and the reduction of complications. The amelioration of diabetes distress could improve self-care even in the presence of pervasive, chronic social stressors such as microaggressions.
•We analyzed dual trajectories of Indigenous adolescent marijuana and alcohol use.•Four groups emerged: non-use (34%); alcohol only (14%); and two co-use groups.•Early marijuana use was linked to ...early alcohol use.•Infrequent alcohol use was linked to abstaining from marijuana use.•Co-users of alcohol and marijuana in adolescence had poorer outcomes in adulthood.
The current study examined the developmental interrelationships between alcohol and marijuana use trajectories from ages 10 to 18 years in a sample of North American Indigenous adolescents. Distinct co-use groups were formed to create profiles of young adult outcomes.
Dual group-based trajectory models of marijuana and alcohol frequency were estimated using data from a longitudinal community-based participatory study of Indigenous adolescents from the upper Midwest and Canada. Joint probabilities were used to create co-use groups, and profiles were created using early adult (Mean Age – 26.28 years) outcomes.
Four joint trajectory groups were identified: 1) no marijuana and no/low alcohol use (34.4%), 2) mid-onset alcohol only (14%), 3) mid-onset co-use starting at age 13 (24%), and 4) early-onset co-use starting at age 11 (22%). High probabilities existed that adolescents would use marijuana early if they began drinking alcohol at the youngest ages, and that adolescents would not use marijuana if they drank infrequently or delayed drinking until mid-adolescence. Adult outcomes were poorer for the early- and mid-onset co-use groups, but there were few differences between the no/low use and alcohol-only groups.
Co-use of marijuana and alcohol was associated with poorer outcomes in early adulthood, particularly for the group with an earlier age of onset. Abstaining from either substance in adolescence was associated with better outcomes.
The purpose of the study was to examine prospective childhood risk factors for gang involvement across the course of adolescence among a large 8-year longitudinal sample of 646 Indigenous (i.e., ...American Indian and Canadian First Nations) youth residing on reservation/reserve land in the Midwest of the United States and Canada. Risk factors at the first wave of the study (ages 10–12) were used to predict gang involvement (i.e., gang membership and initiation) in subsequent waves (ages 11–18). A total of 6.7% of the participants reported gang membership and 9.1% reported gang initiation during the study. Risk factors were distributed across developmental domains (e.g., family, school, peer, and individual) with those in the early delinquency domain having the strongest and most consistent effects. Moreover, the results indicate that the cumulative number of risk factors in childhood increases the probability of subsequent gang involvement. Culturally relevant implications and prevention/intervention strategies are discussed.
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