ABSTRACT
This study examined tribal members' perspectives on alcohol, risk factors, consequences, and community responses. Focus groups were conducted with five American Indian tribes between 1997 and 2001. Participants were knowledgeable of the cultural lives of their reservation communities. Although there was agreement regarding the pervasiveness of heavy drinking, participants reported different opinions about the meaning of alcohol and appropriate intervention strategies. Three dilemmas were identified, suggesting that community ambivalence may serve as a barrier to reducing problem drinking. Implications, limitations, and future research directions are discussed. The study was funded by the National Institute on Alcohol Abuse and Alcoholism.
Subject(s)
Alcohol Drinking/ethnology , Alcoholism/ethnology , Health Knowledge, Attitudes, Practice , Indians, North American/psychology , Alcohol Drinking/psychology , Alcoholism/psychology , Culture , Focus Groups , Humans , Residence Characteristics , Risk FactorsABSTRACT
Prevalence and correlates of adult physical assault and rape in six Native American tribes are presented (N = 1,368). Among women, 45% reported being physically assaulted and 14% were raped since age 18 years. For men, figures were 36% and 2%, respectively. Demographic characteristics, adverse childhood experiences, adulthood alcohol dependence, and cultural and regional variables were assessed. Using logistic regression, predictors of physical assault among women were marital status, an alcoholic parent, childhood maltreatment, and lifetime alcohol dependence. Predictors of sexual assault among women were marital status, childhood maltreatment, and lifetime alcohol dependence. Among men, only childhood maltreatment and lifetime alcohol dependence predicted being physically assaulted. Tribal differences existed in rates of physical assault (both sexes) and rape (women only). The results underscore the problem of violence victimization among Native Americans and point to certain environmental features that increase risk of adulthood physical and sexual assault. Implications for tribe-specific interventions are discussed.
Subject(s)
Alcohol Drinking/epidemiology , Indians, North American/statistics & numerical data , Rape/statistics & numerical data , Spouse Abuse/statistics & numerical data , Adult , Aged , Alcohol Drinking/psychology , Comorbidity , Female , Humans , Indians, North American/psychology , Logistic Models , Male , Middle Aged , Prevalence , Rape/psychology , Risk Factors , Spouse Abuse/psychology , Surveys and QuestionnairesABSTRACT
BACKGROUND: Alcohol abuse and alcoholism are leading causes of death among Native Americans. Little is known about the impact of negative childhood exposures, including parental alcoholism, childhood maltreatment, and out-of-home placement, on risk of lifetime DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) diagnosis of alcohol dependence in this population. METHODS: Face-to-face interviews were conducted with 1660 individuals from seven Native American tribes from 1998 to 2001. Logistic regression was used to estimate the impact of specific types and number of different adverse childhood experiences on alcohol dependence. Relationships between tribe-specific cultural characteristics and alcohol dependence were also examined. RESULTS: There were significant tribal differences in rates of alcohol dependence and several adverse childhood exposures. Lifetime prevalence of alcohol dependence was high among all tribes (men: 21%-56%, women: 17%-30%), but one (men: 1%, women: 2%). High prevalence rates were documented for one or more types of adverse childhood experiences (men: 74%-100%; women: 83%-93%). For men, combined physical and sexual abuse significantly increased the likelihood of subsequent alcohol dependence (odds ratio [OR]=1.58; 95% confidence interval [CI], 1.10-2.27). For women, sexual abuse (OR=1.79; 95% CI, 1.21-2.66) and boarding school attendance increased the odds of alcohol dependence (OR=1.57; 95% CI, 1.03-2.40). Two separate patterns of dose-response relationships were observed for men and women. Significant inter-tribal differences in rates of alcohol dependence remained after accounting for tribe-specific cultural factors and geographic region. CONCLUSIONS: Effects of childhood exposures on high-risk behaviors emphasize screening for violence in medical settings and development of social and educational programs for parents and children living on and near tribal reservations.
Subject(s)
Alcoholism/ethnology , Child Abuse/ethnology , Foster Home Care , Indians, North American/psychology , Adult , Aged , Aged, 80 and over , Alcoholism/epidemiology , Child , Child Abuse/statistics & numerical data , Female , Foster Home Care/psychology , Humans , Indians, North American/statistics & numerical data , Logistic Models , Male , Middle Aged , Prevalence , Risk-Taking , United States/epidemiologyABSTRACT
Focus groups provide a source of data that highlight community ideas on a topic of interest. How interview data will be utilized varies by project. With this in mind, we identify ways that focus group data from a particular population (Native American) articulate a health issue of individual tribal concern (alcohol consumption). Taking our analytic framework from linguistics, one of the four fields of inquiry in anthropology, we examine format ties and the performance of humor as stylistic features of tribal focus groups and illustrate how linguistic devices can be used in analyzing aspects of adolescent and adult drinking. Focus group data require systematic review and analysis to identify useful findings that can lead to inquiry points to initiate collaborative work with local experts before the data can be developed and configured into effective program initiatives.