Understanding the Life Histories of Pregnant-Involved Young Aboriginal Women With Substance Use Experiences in Three Canadian Cities

Shahram, Sana; Bottorff, Joan L.; Kurtz, Donna; Oelke, Nelly D.; Thomas, Victoria; Spittal, Patricia M.

doi:10.1177/1049732316657812

Cited by 26 publications

(68 citation statements)

References 34 publications

(34 reference statements)

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“…They suggested that providers should also be educated, so that they share in this deeper understanding about the role of alcohol in perpetuating the intergenerational trauma of colonization, carrying the damage of the past forward and continuing to harm AI/AN people in the present. These findings correspond to those in the published research that explores similar issues (Shahram, S. Z., Bottorff, J. L., Kurtz, D. L. M., Oelke, N. D... (2016) In sum, participants did not see substance use as an isolated incident, but as a behavioral outcome resulting from the interconnected cycle of historical trauma, reduced social and familial support, increased substance use, and contemporary trauma. Therefore, an FASD prevention program in an urban AI/AN community is unlikely to be effective if it focuses solely on: (1) intervening at the time of pregnancy; (2) preventing a substance-exposed pregnancy through the practice known as screening brief intervention and referral to treatment (SBIRT); and 3prescription of a long-acting contraceptive method if substance use cannot be prevented while a woman is sexually active.…”

Section: Discussionsupporting

confidence: 87%

An indigenous framework of the cycle of fetal alcohol spectrum disorder risk and prevention across the generations: historical trauma, harm and healing

Gonzales

Jacob

Mercier³

et al. 2018

Ethnicity & Health

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Effective, multiple-level FASD prevention approaches for AI/ANs may include prioritizing Indigenous culture, supporting intergenerational cohesion, focusing on non-stigmatic healing of traumas, and authentically engaging community knowledge. This work draws on community and cultural strengths in an effort to reduce the occurrence of substance-exposed pregnancies, and encourages transformational changes in systems that serve AI/AN peoples to promote a healthy and thriving community and future generations.

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Section: Discussionsupporting

confidence: 87%

An indigenous framework of the cycle of fetal alcohol spectrum disorder risk and prevention across the generations: historical trauma, harm and healing

Gonzales

Jacob

Mercier³

et al. 2018

Ethnicity & Health

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“…Mobile phones were also seen as an opportunity to support health and well-being in the context of pregnancy and parenting. Previous Cedar research among young Indigenous mothers observed that being able to parent their children was key to participants’ own wellness, while those whose children had been taken into care expressed feelings of deep regret and loss [ 41 ]. Participants in this study included pregnant mothers preparing for birth, parents of children currently in care of the state who were interested in visitation and regaining custody, and parents with custody of children who were navigating ongoing relationships with social workers as well as trying to protect their children’s health and safety.…”

Section: Discussionmentioning

confidence: 99%

The Cedar Project - Mobile Phone Use and Acceptability of Mobile Health Among Young Indigenous People Who Have Used Drugs in British Columbia, Canada: Mixed Methods Exploratory Study

Jongbloed

Pearce

Thomas

et al. 2020

JMIR Mhealth Uhealth

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Background Indigenous leaders continue to be concerned about high rates of HIV and barriers to HIV treatment among young Indigenous people involved in substance use. Growing evidence suggests that using mobile phones for health (mHealth) may be a powerful way to support connection with health services, including HIV prevention and treatment. Objective This study examined the patterns of mobile phone ownership and use among young Indigenous people who have used drugs living with or vulnerable to HIV and explored the acceptability of mHealth to support access to health care in this population. Methods The Cedar Project is a cohort study involving young Indigenous people who have used drugs in Vancouver and Prince George, British Columbia. This mixed methods exploratory study involved 131 Cedar Project participants enrolled in our WelTel mHealth program. At enrollment, participants completed a questionnaire related to mobile phone use and interest in mHealth. Data were linked to Cedar Project questionnaires and serodata. We present comparative statistics (quantitative) and results of a rapid thematic analysis (qualitative) related to mobile phone patterns and interest in receiving mHealth. Results Less than half of the participants (59/130; 45.4%) reported owning a phone. Among those with a phone, the majority owned a smartphone (46/59; 78%). Most participants with a phone reported having an unlimited texting plan (39/55; 71%), using the internet on their phone (44/59; 75%), and texting daily (44/55; 80%). A majority reported that using a mobile phone for health would be invaluable (120/130; 92.3%). There were no differences in mHealth acceptance between participants who owned a phone and those who did not (P>.99). All but one participant living with HIV felt using a mobile phone would be helpful for their health, while a small proportion of HIV-negative participants remained unsure (1.9% vs 11.7%; P=.047). In response to open-ended questions asking why using a mobile phone may be helpful for health, participants identified a diverse set of anticipated benefits: (1) connection for emotional, mental, and spiritual support, (2) connection to family, (3) staying in touch and/or being reachable, (4) overcoming current barriers to phone use, (5) convenience, privacy, and safety, and (6) access to health care and emergency services. Conclusions We observed high acceptance and interest in using mobile phone technology for health despite low rates of personal mobile phone connectivity among young Indigenous people who have used drugs living with and vulnerable to HIV in British Columbia, Canada. Mobile phones were viewed as a way to support connections and relationships that are seen as critical to health and well-being among young Indigenous people in this study. Findings may be useful for health care providers preparing to scale up mHealth programs to support HIV prevention and treatment in this population.

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“…Further, highlighting the structural and social determinants of substance use provides actionable targets for interventions that can support women and their children. Importantly, by including the variables in this analysis related to women’s socio-political-historical contexts, we were able to present a fuller depiction of women’s actual lives, in keeping with previous qualitative findings from work with this same population [ 23 , 24 ]. Indeed, a common criticism of quantitative research is its inability to produce rich and contextualized data.…”

Section: Discussionmentioning

confidence: 64%

The Cedar Project: Using Indigenous-Specific Determinants of Health to Predict Substance use among Young Pregnant-Involved Indigenous Women In Canada

et al. 2017

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BackgroundIndigenous women in Canada have been hyper-visible in research, policy and intervention related to substance use during pregnancy; however, little is known about how the social determinants of health and substance use prior to, during, and after pregnancy intersect. The objectives of this study were to describe the social contexts of pregnant-involved young Indigenous women who use substances and to explore if an Indigenous-Specific Determinants of Health Model can predict substance use among this population.MethodsUsing descriptive statistics and hierarchical logistic regression guided by mediation analysis, the social contexts of pregnant-involved young Indigenous women who use illicit drugs’ lives were explored and the Integrated Life Course and Social Determinants Model of Aboriginal Health’s ability to predict heavy versus light substance use in this group was tested (N = 291).ResultsImportant distal determinants of substance use were identified including residential school histories, as well as protective factors, such as sex abuse reporting and empirical evidence for including Indigenous-specific determinants of health as important considerations in understanding young Indigenous women’s experiences with pregnancy and substance use was provided.ConclusionsThis analysis provided important insight into the social contexts of women who have experiences with pregnancy as well as drug and/or alcohol use and highlighted the need to include Indigenous-specific determinants of health when examining young Indigenous women’s social, political and historical contexts in relation to their experiences with pregnancy and substance use.

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Understanding the Life Histories of Pregnant-Involved Young Aboriginal Women With Substance Use Experiences in Three Canadian Cities

Cited by 26 publications

References 34 publications

An indigenous framework of the cycle of fetal alcohol spectrum disorder risk and prevention across the generations: historical trauma, harm and healing

An indigenous framework of the cycle of fetal alcohol spectrum disorder risk and prevention across the generations: historical trauma, harm and healing

The Cedar Project - Mobile Phone Use and Acceptability of Mobile Health Among Young Indigenous People Who Have Used Drugs in British Columbia, Canada: Mixed Methods Exploratory Study

The Cedar Project: Using Indigenous-Specific Determinants of Health to Predict Substance use among Young Pregnant-Involved Indigenous Women In Canada

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