Impacts of alcohol availability on Tribal lands where alcohol is prohibited: A community-partnered qualitative investigation

Abstract

On a Northern Plains reservation where alcohol was prohibited, we investigated community members' views on the impacts of alcohol availability. Our methods combined elements of Tribal community participatory research with qualitative inquiry to elicit these perspectives. We used rapid appraisal techniques to conduct confidential interviews with 31 key leaders representing 7 relevant major community systems, and representing a variety of perspectives. Topics included respondents' understandings of the current systems of alcohol availability and use on the reservation, the impacts of these systems on reservation residents, and possible ways to measure these impacts. Respondents reported impacts on individuals, families, and the tribe overall. Alcohol-related problems shaped and were shaped by a constellation of social-ecological conditions: kinship, housing, employment, public/social service capacity, and the supply of alcohol in nearby off-reservation areas, as well as inter-governmental relationships and the spiritual life of reservation residents. A variety of social-structural determinants magnified alcohol impacts, so that the problem drinking of a small number of individuals could have broad effects on their families and the entire community. Our participatory qualitative methods enabled us to directly include the voices as well as the personal experiences and expertise of community members in this presentation. These methods may be broadly applied within policy analysis to identify ways to reduce harms related to alcohol and other drugs for Indigenous communities.

Measurement Invariance and Application of an Alcohol-Related Consequence Scale for American Indian Adolescents

“…For example, some studies have found AI adolescents who drink alcohol experience alcohol-related consequences not captured on the scale including sexual assault (Kirk-Provencher et al, 2020), suicidality (Cwik et al, 2018), likeliness to run away, to smoke, to use more drugs, and to have sex (Mitchell et al, 2008). Other studies have reported AI who live on reservations to experience alcohol-related consequences shaped by a constellation of social-ecological conditions including kinship, housing, public/social service capacity, the supply of alcohol in nearby off-reservation areas, as well as inter-governmental relationship and the spiritual life on reservation residents (Lee et al, 2018). AI adolescents may be facing unique alcohol-related consequences that are not measured in the ADAS alcohol-related consequences scale given that it was not created within a reservation-based AI community.…”

Where there’s a will, there’s a way? Strategies to reduce or abstain from alcohol use developed by Northern Plains American Indian women participating in a brief, alcohol‐exposed pregnancy preconceptual intervention

“…Finally, some participants reported they would not use cultural strengths because they "respect the culture" too much to engage in cultural activities if they are using alcohol. A belief that spiritual practices and intoxication must remain separate (Lee et al, 2018) may lead some individuals may not feel that they are allowed to or may not want to engage in cultural practices if they are still drinking.…”