Tailoring an Alcohol Intervention for American Indian Alaska Native Women of Childbearing Age: Listening to the Community

Montag, Annika C.; Dusek, Marlené L.; Ortega, Marina L.; Camp-Mazzetti, Alexandrea; Calac, Dan; Chambers, Christina D.

doi:10.1111/acer.13485

Cited by 12 publications

(16 citation statements)

References 43 publications

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“…However, this research did not evaluate or estimate the potential social or emotional consequences of reducing or changing alcohol use. Previous research with Native women at risk for AEP did explore the effects of depression on risky drinking, but not the impact of changing one’s social setting to reduce or alter drinking patterns (Montag et al, 2015a, Montag et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

The Importance of Understanding Social Context in the Reduction of AEP Risk among Native Women

Hanson

Mohawk

Shrestha

et al. 2020

Alcoholism Clin & Exp Res

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Section: Discussionmentioning

confidence: 99%

The Importance of Understanding Social Context in the Reduction of AEP Risk among Native Women

Hanson

Mohawk

Shrestha

et al. 2020

Alcoholism Clin & Exp Res

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“…Prevention efforts can be hampered by language barriers and cultural differences [ 59 ] . To ensure culturally appropriate, reliable and sustainable interventions for Indigenous peoples, it has been recommended to include members from the priority population in all steps of program planning, integrate culture into the interventions when creating or adapting program components [ 63 , 64 ], and conduct evaluations with the support and inclusion of communities [ 65 ]. Despite being detrimentally impacted by similar consequences of colonisation, Indigenous populations around the World are heterogenous.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities

et al. 2018

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BackgroundFetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work.MethodThe MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO, SocINDEX, and Informit databases were searched from inception to 22/08/2017 for all prevention and intervention papers published in peer-reviewed scientific journals, with results, targeting prenatal alcohol exposure and FASD in Indigenous populations. This review was limited to studies published in English and excluded interventions focusing on the workforce. All steps were completed independently by two reviewers with discrepancies resolved via consensus with the senior author.ResultsThere was significant heterogeneity in the ten included studies. Populations targeted included non-pregnant women of child-bearing age, pregnant women, school children and the general public. Study designs included one randomised controlled trial, five cohort studies with pre-post design, one cross-sectional study with different pre- and post-intervention groups, and four studies collected post-intervention data. Studies assessed changes in knowledge, and/or changes in risk for prenatal alcohol exposure including self-reported alcohol consumption, use of birth control or a combination of both. One study was conducted in Australia and nine in the US. The methodological quality of all studies was rated as ‘Poor’ using the systematic review assessment tools developed by The National Heart, Lung and Blood Institute. Studies were subject to substantial bias due to issues such as high loss to follow-up, lack of control groups and the reliance on self-report measures to assess the main outcome.ConclusionOverall, there is little evidence that previous interventions aiming to reduce the risk of prenatal alcohol exposure or FASD in Indigenous populations have been effective. Future intervention studies should address the cultural factors and historical context that are fundamental to successful work with Indigenous populations, and be designed, implemented and evaluated using rigorous methods.This systematic review was registered with PROSPERO, CRD42018086212.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6139-5) contains supplementary material, which is available to authorized users.

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“…Paper and pencil questionnaire. These questions were the result of feedback from the community obtained through a focus group and interview process described in detail elsewhere (Montag et al, 2017). Topics included whether and, if yes, when women felt pressured to drink; why they drank when they binge drank and why they chose not to when they did not drink; who they drank with when they were binge drinking and questions about this person's drinking; and whether they had experienced trauma or abuse.…”

Section: Sample Subgroupsmentioning

confidence: 99%

“…Approval and support was obtained from the Tribal IRB. Preparation of materials (detailed elsewhere, Montag, et al, 2017), recruitment, and interactions with participants were carried out by trusted community members trained as research staff. Participants were self-selected volunteers and may not represent all women of child-bearing age within the community.…”

Section: Limitationsmentioning

confidence: 99%

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

Montag¹,

Calac²,

Chambers³

2019

IJIH

Self Cite

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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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Tailoring an Alcohol Intervention for American Indian Alaska Native Women of Childbearing Age: Listening to the Community

Abstract: This study may inform the modification of future interventions among AIAN communities.

Cited by 12 publications

References 43 publications

The Importance of Understanding Social Context in the Reduction of AEP Risk among Native Women

The Importance of Understanding Social Context in the Reduction of AEP Risk among Native Women

A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities

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

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