Abstract: A Qualitative Exploration of Motives for Binge Alcohol and Substance Use Among American Indian Adolescents (Society for Prevention Research 23rd Annual Meeting)

Schedule:

Thursday, May 28, 2015

Congressional D (Hyatt Regency Washington)

* noted as presenting author

Lauren Tingey, MPH, MSW, Research Associate, Johns Hopkins University, Baltimore, MD

Mary Cwik, PhD, Assistant Scientist, The Johns Hopkins University, Baltimore, MD

Novalene Goklish, BA, Senior Research Program Coordinator, The Johns Hopkins University, Whiteriver, AZ

Francene Larzelere-Hinton, BA, Senior Research Program Coordinator, The Johns Hopkins University, Whiteriver, AZ

Angelita Lee, BA, Senior Research Program Coordinator, Johns Hopkins University, Baltimore, MD

Rosemarie Suttle, AA, Research Program Coordinator, The Johns Hopkins University, Whiteriver, AZ

Rachel Strom, MPH, Research Associate, The Johns Hopkins University, Baltimore, MD

Allison Barlow, PhD, Assistant Scientist, The Johns Hopkins University, Baltimore, MD

Introduction: Despite high rates of abstinence, American Indians also have the highest rate of alcohol consumption and related morbidity and mortality of all U.S. groups, particularly adolescents. American Indian adolescents initiate alcohol and substance use earlier, more frequently binge, and meet criteria for abuse and dependence than other racial/ethnic groups. Understanding motivations, particularly for binge use, is important to designing prevention and intervention initiatives specific to this at-risk population.

Methods: In this study we explore motivations for binge alcohol and drug use, including the four-factor motives model (i.e., enhancement, social, coping and conformity), in addition to protective factors among a sample of American Indian adolescents ages 10-19 (50% male) from a rural, reservation-based tribal community in the Southwest. This was a mixed-methods, cross-sectional, case-control study. Results are presented from 40 qualitative in-depth individual interviews conducted with 21 cases who had engaged in recent binge alcohol or substance use and 19 healthy controls. Analysis included research team data coding, triangulation through multiple researcher perspectives, cultural auditing, and research team consensual analysis.

Results: Case participants endorsed conformity and coping motives most often. Positive reinforcement motives did not separate distinctly into social and enhancement classes, similar to that found in other indigenous samples. In addition, case participants failed to connect the impact of their current behaviors on long-term goals, were disengaged from school and did not spend free time in structured programs or activities. All participants described deep, multilayered family relationships, with female providers playing primary care-giving roles. Peers were also influential in promotion or abstention from alcohol and substance use.

Conclusions: Results prescribe intervention and prevention strategies that include tribally-led policy change in the regulation of alcohol sales, increasing expectations for adolescents’ academic achievement, positive orientation to school, and involvement in pro-social activities. Family-based intervention should focus on increasing parental monitoring, addressing family-based substance use, reinforcement of family protective factors, and engagement with community-based resources to help adolescents and parents maintain positive behavior change. Peer-based intervention may also be effective at changing group-based norms and attitudes around substance use in salient social networks. Future directions include piloting individual, peer and family-based brief interventions for American Indian adolescent binge alcohol and substance users.

Abstract: A Qualitative Exploration of Motives for Binge Alcohol and Substance Use Among American Indian Adolescents (Society for Prevention Research 23rd Annual Meeting)

280 A Qualitative Exploration of Motives for Binge Alcohol and Substance Use Among American Indian Adolescents