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BACKGROUND AND OBJECTIVES: There has been a prevailing but erroneous belief in the medical community that there is a biological vulnerability in the American Indian/Alaskan Native (AI/AN) community to substance use disorders (SUDs), with alcohol use disorder (AUD) being the most prevalent. This scoping review aimed to examine what possible psychosocial issues could lead to the development of the perpetuation of SUDs in the AI/AN population. METHODS: The protocol for this scoping review followed Arksey and O'Malley's methodological framework. There were 405 articles included for full-text review. Further inclusion criteria were applied which included: Directly looking at participants who had a SUD, including either in the discussion or conclusion a statement linking their data to psychosocial issues as a possible explanation for their data, and having measured the psychosocial issue with a research device. The final review included 15 studies. RESULTS: Four psychosocial themes were uncovered using an inductive process, where recurring words related to identity, prejudice, isolation, discrimination, and self-concept in the literature. These themes were trauma/historical loss, mood, and discrimination/self-esteem. All of these themes are interrelated, and all influence the development or sustainment of a SUD. DISCUSSION AND CONCLUSIONS: Complex psychosocial factors in the AI/AN community are associated with SUDs. This trauma and historical loss should be addressed with culturally tailored treatments. SCIENTIFIC SIGNIFICANCE: There are not many manuscripts that specifically look at the interplay of mood, trauma, self-worth, and discrimination with SUD in the AI/AN community. This scoping review aims to highlight these issues as well as discuss how culture should play a part in treatment.
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INTRODUCTION: Health research that focuses on Indigenous Peoples must ensure that the community in question is actively engaged, and that the results have context relevance for Indigenous Peoples. Context relevance is "the benefits, usability, and respectful conduct of research from the perspective of Indigenous communities." The purpose of this study was to apply two tools within an already-published scoping review of 76 articles featuring research on cognitive impairment and dementia among Indigenous Peoples worldwide. One tool assessed levels of community engagement reported in the corpus, and the other tool assessed the context relevance of recommendations in the corpus. We hypothesized that research with higher levels of reported community engagement would produce recommendations with greater context relevance for Indigenous Peoples. METHODS: We employed semi-structured deductive coding using two novel tools assessing levels of reported community engagement and context relevance of recommendations based on studies included in the existing scoping review. RESULTS: Application of the two tools revealed a positive relationship between increasing community engagement and greater context relevance. Community engagement primarily occurred in studies conducted with First Nations, Inuit, and Métis populations in Canada and with Australian Aboriginal and/or Torres Strait Islander Peoples. Research with Alaska Native, American Indian, and Native Hawaiian Peoples in the USA stood out for its comparative lack of meaningful community engagement. DISCUSSION: There is opportunity to utilize these tools, and the results of this assessment, to enhance training and mentorship for researchers who work with Indigenous populations. There is a need to increase investigator capacity to involve communities throughout all phases of research, particularly in the pre-research stages.