Factors That Influence Substance Use Among American Indian/Alaskan Native Youth: A Systematic Mixed Studies Review

Abstract

BACKGROUND: The American Indian/Alaskan Native (AI/AN) mortality rate from illicit drug use was 22.7%, double that of the general population between 2007 and 2009. Fifteen percent of AI/AN youth reported receiving treatment for substance use compared with 10% of non-AI/AN peers. OBJECTIVE: The purpose was to explore the factors that influence substance use among AI/AN youth. METHOD: We performed a systematic review using a results-based convergent synthesis design. Eight electronic databases were searched for articles published between 2014 and 2019 using the search terms “Native American youth,” “Native American adolescent,” “Native Youth,” “substance use,” “substance misuse,” and “substance abuse.” The Mixed Methods Appraisal Tool was used to appraise the studies. RESULTS: Forty-seven studies met the inclusion criteria (44 quantitative, one qualitative, and two mixed-methods studies). The results were organized using the ecological systems model and included evaluation of both protective and risk factors related to AI/AN youth substance use. Three system levels were found to influence substance use: individual, micro- and macrosystems. The individual systems-level coping mechanisms played a key role in whether AI/AN youth initiated substance use. Family, school, and peer factors influence the microsystem level. At the macrosystem level, community environmental factors were influential. CONCLUSION: The major factor linking all the systems was the influence of a connected relationship with a prosocial adult who instilled future aspirations and a positive cultural identity. Findings of this systematic mixed studies review will assist in intervention development for AI/AN youth to prevent substance misuse.

Risk and protective factors of social networks on alcohol, cannabis, and opioid use among urban American Indian/Alaska Native emerging adults.

“…However, many urban AI/AN emerging adults have difficulty accessing cultural resources (D’Amico et al, 2021; Dickerson et al, 2022) and often feel isolated from their traditional ways (Johnson et al, 2021) due to being geographically fragmented in urban areas and also often far from their reservation or tribal lands. One way to connect urban AI/AN emerging adults with their culture is by focusing on helping them develop supportive social networks with whom they can share traditions (Kennedy, D’Amico, et al, 2022; Philip et al, 2016; Woods et al, 2022).…”

Intersecting sex and American Indian identity moderates school and individual correlates of binge drinking among reservation-area adolescents.

“…Adolescents in two-parent households generally drink less alcohol than those in other households (Khlat et al, 2020). Social bonding theories hypothesize several mechanisms of this protective effect, including more effective parental monitoring, better parent–child relationships, and increased family support (Grevenstein et al, 2020; Woods et al, 2022). Although the relationship between AI adolescents’ family structure and behavioral risk is less studied, recent works have indicated that two-parent households are protective (Andreescu, 2019; D.…”

“…Studies using non-AI samples indicate a heightened risk of alcohol use and other risk behaviors among female adolescents not living with both parents (Hemovich & Crano, 2009), though sex differences in risk and protective factors of BD vary according to ethnicity (Areba et al, 2018). Sex has been examined primarily as a covariate rather than a moderator of family structure’s effects in AI populations (Woods et al, 2022), and studies investigating intervening variables between family structure and AI substance use have yielded few sex differences (Ayers et al, 2021).…”

“…Our findings suggest that two-parent households are more likely to prevent AI female adolescents' initial choice to BD; whereas they appear more likely to mitigate AI male adolescents' recurring BD. Parental monitoring is a common explanatory effect of family structure (Woods et al, 2022), and parents, including AI parents, tend to monitor female adolescents more closely than male adolescents (Boyd-Ball et al, 2014). Researchers often ascribe similar findings to patriarchal gender norms (Van Gundy et al, 2005); however, reservation-area AI parents may monitor their daughters more closely because of the disproportionate risk of sexual violence experienced by Indigenous women and girls within their communities (Gordon & Robers, 2021).…”

Parental Presence, Deviant Behaviours and Alcohol/Drugs Use in Adolescents: The Results of the International Self-Report Delinquency Study 3

“…A more recent hypothesis states that the relations between the two phenomena are not directly linked but derive from common external or internal factors, which work as risk or protective factors of deviant behaviors [14]. Among them, experiences within the family play an important role [15][16][17][18][19].…”