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Cited by 6Substance Abuse Treatment and OutcomesIndigenous Health, Education, and RightsPrenatal Substance Exposure Effects

Community-Specific Risk and Protective Factors for Risky Alcohol Consumption in American Indian Women of Reproductive Potential: Informing Interventions

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Montag, Annika C, Calac, Daniel J, Chambers, Christina D·2019·International Journal of Indigenous Health
DOI 10.32799/ijih.v14i1.31944
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Abstract

Objective: To explore the effect of community-specific risk and protective factors on risky alcohol consumption and vulnerability to having an alcohol-exposed pregnancy in women within a Southern California American Indian community. Methods: A sample of 343 American Indian women of childbearing age was enrolled in a study of risky drinking. All participants completed a questionnaire including alcohol consumption, other health behaviors, the T-ACE risky alcohol consumption screen and the PHQ-9 to measure depression and functionality. A subset of 80 women additionally answered focus group-derived questions about why they choose or do not choose to drink. Results: Risk and protective factors varied among sample subgroups. Broadly, factors affecting risk and protection included: depression, perception of other women’s drinking, children/family, perception of risk to the unborn child, and feeling pressured to drink. Women’s drinking was highly influenced by female friends and relatives. Women were most likely to drink with a girlfriend. Nearly 40% of all participants asked felt pressured to drink. Depression was associated with riskier alcohol consumption, less effective contraception, and testing positive for risky drinking using the T-ACE screen. Depressed women were more likely to binge drink because of stress, trauma, and “to escape my problems”, and more likely to have been exposed to trauma including sexual assault. Conclusions: Interventions should incorporate community-specific factors. In the present sample, two separate strategies are indicated by the data: an information campaign to increase women’s awareness of true social norms and the risks of prenatal alcohol-exposure; and screening for and treating depression.

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Crossref · 10.32799/ijih.v14i1.31944

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68 of 68 references verified0 citation errors · 0 not checkable

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  • Depressive symptoms and clinical depression are significantly associated with substance use among AIAN.

    “Depressive symptoms and clinical depression are significantly associated with substance use among AIAN [30,48].”

    From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [48]

    The Discussion reports that depression was an independent risk factor for risky drinking in the study’s AIAN women, but says the difference between nondrinkers and current drinkers was not significant. The Measures section defines depression by a PHQ-9 screening score, not a clinical diagnosis. The source therefore supports a narrower association with risky alcohol use, not the claim about clinical depression and substance use across AIAN populations. (LLM, conf=0.87)

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  • Parental and other family members' substance use was associated with increased likelihood of substance use among AIAN youth.

    “Parental and other family members’ substance use was associated with increased likelihood of substance use among AIAN youth [48,64,65].”

    From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [48]

    The Discussion (page not specified) says that female friends and family members influenced drinking among the women studied, and the Subset Sample reports that some women binge drank with a parent, sibling, or cousin. But the Sample Source identifies participants as AIAN women aged 18–45; the paper does not establish an association between family members’ substance use and substance use among AIAN youth. (LLM, conf=0.83)

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  • Drinking with family members or peers who drink lower amounts of alcohol compared to socializing with people who drink a lot can be protective against developing a more severe SUD.

    “Drinking with family members or peers who drink lower amounts of alcohol compared to socializing with people who drink a lot can also be protective against developing a more severe SUD [48].”

    From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [48]

    The Discussion (page not specified) says female friends and family members influence participants’ drinking, and Implications for Prevention (page not specified) recommends supportive friend networks. Neither passage compares drinking with lighter versus heavier drinkers or examines whether doing so prevents a more severe substance use disorder. (LLM, conf=0.78)

    Experimental — accuracy not yet measured

  • Decision making and problem-solving skills appear to be protective for SUD.

    “Decision making and problem-solving skills also appear to be protective for substance use disorder (SUD) [48]”

    From Substance and Behavioral Addictions among American Indian and Alaska Native Populations (2022) · cites this paper as [48]

    The Discussion (page not supplied) says nondrinkers’ reasons for abstaining tended to reflect more considered, longer-term decisions than drinkers’ reasons, which lends some support to the decision-making part. It does not assess problem-solving skills or establish either skill as protective against substance use disorder; the study concerns risky alcohol consumption in a specific group of women. (LLM, conf=0.83)

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Cites

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Research works printed but not linked: 4

  1. Branco, E., & Kaskutas, L. (2001). "If it burns going down…": How focus groups can shape fetal alcohol syndrome (FAS) prevention. Substance Use & Misuse, 36(3), 333-345. doi:10.1081/JA- 100102629 · DOI
  2. Hawkins, J. D., Van Horn, M. L., & Arthur, M. W. (2004). Community variation in risk and protective factors and substance use outcomes. Prevention Science, 5(4), 213-220. doi:10.1023/B:PREV.0000045355.53137. · DOI
  3. O'Connor, M. J., & Whaley, S. E. (2006b). Health care provider advice and risk factors associated with alcohol consumption following pregnancy recognition. Journal of studies on alcohol and drugs, 67(1), 22.
  4. Spicer, P., Beals, J., Croy, C. D., Mitchell, C. M., Novins, D. K., Moore, L., . . . Protective Factors Project, T. (2003). The Prevalence of DSM-III-R Alcohol Dependence in Two American Indian Populations. Alcoholism: Clinical and Experimental Research, 27(11), 1785-1797. doi:10.1097/01.alc.0000095864.45755. · DOI

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Authors
Montag, A. C., Calac, D. J., & Chambers, C. D.
Affiliations
University of California San Diego (US)
Corresponding author
Montag, Annika C
ORCID
Venue
International Journal of Indigenous Health
Publisher
University of Toronto Libraries - UOTL
Published
2019-04-10
Volume
14
Issue
1
Pages
8-28
ISSN
  • 2291-9368 (ISSN-L)
  • 2291-9376
DOI
10.32799/ijih.v14i1.31944
OpenAlex
W2947273579
Cited by
6
References
68
Citations by year
2026: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2019: 1
FWCI
0.76
Type
journal article
Language
en
Open access
Licence
Locations
International Journal of Indigenous Health (publishedVersion, cc-by-nc-nd)
Funders
National Institute of General Medical Sciences (GM087518)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Health › Indigenous Health, Education, and Rights
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Keywords
risky alcohol use, American Indian women, alcohol-exposed pregnancy, prenatal alcohol exposure, depression, social norms, peer pressure, trauma, sexual assault, binge drinking, contraception, alcohol screening

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