Reducing Underage Drinking A Collective Responsibility (2004) / Chapter Skim
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14 Preventing Underage Drinking in American Indian and Alaska Native Communities: Contexts, Epidemiology, and Culture--Douglas K. Novins, Paul Spicer, Janette Beals, and Spero M. Manson
14 Preventing Underage Drinking in American Indian and Alaska Native Communities: Contexts, Epidemiology, and Culture--Douglas K. Novins, Paul Spicer, Janette Beals, and Spero M. Manson
Pages 678-696
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From page 678... ...
This paper from the National Center for American Indian and Alaska Native Mental Health Research, University of Colorado Health Sciences Center, Aurora, was commissioned by the National Academy of Sciences Committee on Developing a Strategy to Reduce and Prevent Underage Drinking. The authors acknowledge the contributions of Drs.
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From page 679... ...
We will include descriptions of the key contexts and epidemiology of underage drinking among AI/ANs, prevention efforts to date, and the role of cultural constructs in understanding and preventing underage drinking and related problems. KEY CONTEXTS Sociodemographics AI/ANs are a diverse and heterogeneous population.
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Department of Health and Human Services and Indian Health Service, 1997)
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NATURE AND EXTENT OF UNDERAGE DRINKING IN AMERICAN INDIAN AND ALASKA NATIVE COMMUNITIES A series of community-based studies provides critical information regarding the prevalence and correlates of underage drinking. Beauvais and colleagues have conducted an ongoing annual survey of AI 7th to 12th graders that has been a key resource for monitoring the prevalence and patterns of alcohol and drug use among rural reservation AI adolescents since 1975.
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This study generated Diagnostic and Statistical Manual of Mental Disorders-based diagnoses (American Psychiatric Association, 1994) of alcohol and drug abuse/dependence as well as a number of psychiatric disorders (e.g., major depression)
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The relationships of alcohol use to drug use and nonsubstance use psychiatric disorders are amplified by our recent study of 89 AI adolescents admitted to a residential substance abuse treatment facility (Novins, Fickenscher, and Manson, 2002a)
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Aboriginal social organization, societal disruption, ethnic identity, and historical trauma are the most commonly mentioned cultural constructs that may be related to underage drinking and related problems, although researchers have had difficulty identifying relationships between their operationalizations of these constructs and underage drinking and related problems. We will consider each of these constructs in turn.
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From page 685... ...
The integration of these two separate dimensions by May (1982) generated a 2 × 3 typology in which societies could have high, medium, or low levels of integration in their aboriginal social organization as well as higher or lower levels of acculturative stress because of their subsequent historical experiences (May, 1982)
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From page 686... ...
In our analysis of data from the Voices of Indian Teens Study, we examined explicitly the relationship between May's 2 × 3 typology of aboriginal social organization and social disruption described above with alcohol use among 1,923 youth from four culturally distinct AI tribes. In addition, we examined whether tribal differences could be explained by other variables such as gender, age, parental alcohol use, stressful life events, and association with alcohol-using peers (Spicer, Novins, Mitchell, and Beals, 2003)
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From page 687... ...
For AI/AN communities, these historical traumas include genocidal experiences such as war, massacres, seizure of tribal lands, forced migration to reservations, forced attendance at boarding schools, laws outlawing traditional practices, racism, and induced migration from reservations to urban areas (Gray, 1998; Novins et al., 2001b)
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PREVENTION EFFORTS IN AMERICAN INDIAN/ALASKA NATIVE COMMUNITIES A variety of prevention efforts have been pursued in AI/AN communities, many of which have included a focus, but rarely an exclusive one, on underage drinking. For the purposes of this discussion, we will divide them into two groups: policy focused and population focused.
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From page 689... ...
. These policies are likely to have had similar impacts on underage drinking, although no data specific to this outcome are available.
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. Though scientists and AI/AN community members have suggested that underage drinking and related problems are associated with a variety of cultural constructs (e.g., aboriginal social organization, social disruption,
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Indeed, results from studies of AI adolescents suggest that underage drinking and related problems are strongly correlated with many of the same factors that are found among non-AIs, including stress, parental alcohol use, and association with alcohol-using peers. However, because of the complexities in operationalizing these cultural constructs (particularly historical trauma, which does not require conscious awareness to have an impact)
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. Traditional and western healing practices for alcoholism in American Indians and Alaska Natives.
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. American Indians and Alaska Natives: Changing societies past and present.
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. Healthy nations: Reducing substance abuse in American Indian and Alaska Native communities.
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. Psychiatric and psychoso cial characteristics of American Indian adolescents entering substance abuse treatment: What evidence do we need?
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. Regional differences in Indian health.
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