Sobriety and alcohol use among rural Alaska Native elders

Skewes, Monica C.; Lewis, Jordan

doi:10.3402/ijch.v75.30476

Cited by 18 publications

(15 citation statements)

References 33 publications

(41 reference statements)

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“…Although communities profess the need for more effective SUD treatments, there is evidence of profound skepticism and resistance to the idea of evidence‐based treatments developed by non‐Native researchers for non‐Native patients being used in AI/AN communities (Calabrese, ; Gone, ; Greenfield & Venner, ; Novins et al., ; Skewes & Lewis, ; Venner et al., ). Respect for culture and tribal sovereignty is perceived to be at odds with mandates to use evidence‐based treatments, and some aspects of efficacious treatments are at odds with AI/AN cultures (Gone, , ; Larios, Wright, Jernstrom, Lebron, & Sorensen, ; Novins et al., ; Venner et al., ).…”

Section: Introductionmentioning

confidence: 99%

Partnering with Native Communities to Develop a Culturally Grounded Intervention for Substance Use Disorder

Skewes

Hallum-Montes

Gardner

et al. 2019

American J of Comm Psychol

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Highlights• Our academic-community partnership was formed to address health disparities in rural Montana.• We conducted in-depth interviews with key informants from a rural American Indian reservation.• Participants desired a holistic, multi-level intervention that involves culture and spirituality. • Next, we will culturally adapt relapse prevention for American Indians with substance use disorder.Abstract Studies have documented serious disparities in drug and alcohol-related morbidity and mortality among American Indians and Alaska Natives (AI/ANs) compared to other ethnic groups in the U.S. despite high rates of abstinence in these groups. Further complicating these health disparities are barriers to accessing evidence-based treatments that are culturally appropriate and acceptable. As part of a research program to promote health equity in rural communities, we developed an academic-community partnership to create a culturally grounded intervention for adults with substance use disorder (SUD) residing on a rural AI reservation. We describe the early phases of our long-term Community Based Participatory Research project and report findings from the first study we conducted. This key informant interview study consisted of in-depth qualitative interviews with 25 tribal members knowledgeable about substance use and recovery on the reservation. The goal was to understand social norms and cultural conceptualizations of substance use to inform the development of a sustainable, community-driven intervention. Participants reported that a holistic approach to recovery that emphasizes spiritual, cultural, and interpersonal harmony and connectedness was important to the community and would be necessary for the intervention to succeed. They also emphasized the need for a multi-level intervention targeting individuals, families, and the community as a whole. Through this initial study, we not only gained valuable information that will be used to guide future research and treatment efforts, but we also strengthened our partnership and built trust with the community. In this manuscript we tell the story of the development of our project and describe our shared vision for future directions.

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Section: Introductionmentioning

confidence: 99%

Partnering with Native Communities to Develop a Culturally Grounded Intervention for Substance Use Disorder

Skewes

Hallum-Montes

Gardner

et al. 2019

American J of Comm Psychol

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“…Alcohol abstinence rates are higher for Alaska Natives than other racial and ethnic minority groups, pointing to important sources of resilience [48,49]. There is a need for continued work in the development of alcohol treatment and relapse prevention programs to address the unique context of Alaska Native people and communities, specifically alcohol treatment for racial and ethnic minority older adults.…”

Section: Discussionmentioning

confidence: 99%

Alaska Natives in Recovery and Indigenous Cultural Generativity: Sharing Redemptive Narratives to Improve Quality of Life

Lewis¹

2020

Global Social Work - Cutting Edge Issues and Critical Reflections

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This chapter explores motivating and maintenance factors for sobriety among older AN adult participants (age 50+) from across Alaska. Alaska Native Elders are motivated to abstain from, or to quit drinking alcohol through spirituality, family influence, role socialization and others' role modeling, and a desire to engage in indigenous cultural generative activities with their family and community. A desire to pass on their accumulated wisdom to a younger generation through engagement and sharing of culturally grounded activities and values, or indigenous cultural generativity, is a central unifying motivational and maintenance factor for sobriety. The social work implications of this research indicates that family, role expectations and socialization, desire for community and culture engagement, and spirituality are central features to both Alaska Native Elders' understanding of sobriety, and more broadly, to their successful aging. Social workers can use motivational interviewing techniques to explore Elders cultural motivations to encourage and support relapse prevention and support older Alaska Native adults' desire to quit drinking and attain Eldership in their family and community. Sobriety can put older Alaska Native adults on a pathway to successful aging, in positions to serve as role models for their family and community, where they are provided opportunities to engage in meaningful indigenous cultural generative acts; roles they have learned about across their lifetime.

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“…While the language was degrading and stigmatizing, the results were also questionable because measures had not been validated in AN people, and the statistical methods had marked limitations (Guilmet, 1989; Trimble, 1989). After this study, many AN people hesitated to participate in research, particularly research about sensitive topics like alcohol misuse (Kraus, 1989; Skewes & Lewis, 2016).…”

Section: History Of Researchmentioning

confidence: 99%

Challenges in Engaging and Disseminating Health Research Results Among Alaska Native and American Indian People in Southcentral Alaska

Dillard¹,

Caindec²,

Dirks³

et al. 2018

AIANMHR

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AMERICAN INDIAN AND ALASKA NATIVE MENTAL HEALTH RESEARCH i FOREWORDWe are delighted to showcase a unique process for reaching out to, engaging, and disseminating research conducted among Alaska Native people. The Southcentral Foundation, notably its Research Department, led by Dr. Denise Dillard and her colleagues -the authors of this special issue − is widely respected for its deep commitment to pursuing research relevant to its customer/owners. Indeed, simply referring to their patient population in this fashion underscores the alignment of their mission, values, and actions. Frankly, I know of no other entity, tribal or otherwise, so fully dedicated in principal as well as practice to ensuring that its research is driven by stakeholders, that the results are translated into terms meaningful to them, that the findings reflect their perspectives, that the attendant insights are applied with local benefit, and that this work is undertaken in a scientifically rigorous manner that contributes to our understanding of the health and well-being of this special population. The articles herein testify to the effort required of such work and the potential return on investment for all participants.Unfortunately, much of today's conversation about outreach to, engagement of, and dissemination among Native communities proceeds at a level of abstraction that offers little guidance about actual process. Not so here. The authors describe in detail the nature of their research, steps taken to communicate findings to key stakeholders, the latter's reactions, and implications for this process. Their candid discussion of the challenges that arose during this endeavor represents a refreshingly authentic analysis of a difficult subject, the mechanics of which are often glossed over in the rush to exhort others to engage tribal communities. Of particular value is the authors' reflection on how the communication strategies available to them through the Southcentral Foundation can be mobilized to maintain the momentum of their initial efforts and to reinforce the reciprocity as well as transparency that characterized this undertaking. The lessons learned, and shared in the pages to follow, are important ones. Thank you for stretching yourselves beyond the typical role of researcher-as-scientist to illustrate these lessons and the wisdom contained therein. Beyond this introduction, the special issue consists of three sections. Section I describes the background information shared with Forum attendees, the structure and content of the Forum itself, and the methods used to gather community feedback. Section II depicts three SCF research studies that disseminated results differently, along with community feedback about clarity of results, sufficiency of information, and the degree to which information was presented in an interesting way. The three research studies concern dissemination of results from a T-SBIRT (i.e., trauma-focused screening, brief intervention, and referral to treatment) process, a stakeholder-driven decision support to...

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Sobriety and alcohol use among rural Alaska Native elders

Cited by 18 publications

References 33 publications

Partnering with Native Communities to Develop a Culturally Grounded Intervention for Substance Use Disorder

Partnering with Native Communities to Develop a Culturally Grounded Intervention for Substance Use Disorder

Alaska Natives in Recovery and Indigenous Cultural Generativity: Sharing Redemptive Narratives to Improve Quality of Life

Challenges in Engaging and Disseminating Health Research Results Among Alaska Native and American Indian People in Southcentral Alaska

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