Consistency in the reporting of sensitive behaviors by adolescent American Indian women: a comparison of interviewing methods.

Computer-assisted interviewing techniques have increasingly been used in program and research settings to improve data collection quality and efficiency. Little is known, however, regarding the use of such techniques with American Indian (AI) adolescents in collecting sensitive information. This brief compares the consistency of AI adolescent mothers' reporting of sensitive sexual and drug use behaviors gathered through three distinct interviewing techniques: computer-assisted (ACASI), self-administered questionnaire (SAQ), and face-to-face interview (FTFI). Endorsement of drug use and reporting of sexual activity was highest for ACASI, followed by SAQ, and was significantly lower for FTFI. Relatively strong agreement was measured between ACASI and SAQ, and relatively poor agreement was measured between the ACASI and FTFI. Findings support the use of computer-assisted interviewing techniques with AI adolescents, and implications for future research are discussed.

Effect of a paraprofessional home-visiting intervention on American Indian teen mothers' and infants' behavioral risks: a randomized controlled trial.

OBJECTIVE: The authors sought to examine the effectiveness of Family Spirit, a paraprofessional-delivered, home-visiting pregnancy and early childhood intervention,in improving American Indian teen mothers' parenting outcomes and mothers'and children's emotional and behavioral functioning 12 months postpartum. METHOD: Pregnant American Indian teens(N=322) from four southwestern tribal reservation communities were randomlyassigned in equal numbers to the Family Spirit intervention plus optimized standard care or to optimized standard care alone. Parent and child emotional and behavioral outcome data were collected at baseline and at 2, 6, and 12 months postpartum using self-reports, interviews,and observational measures. RESULTS: At 12 months postpartum, mothers in the intervention group had significantly greater parenting knowledge parenting self-efficacy, and home safety attitudes and fewer externalizing behaviors,and their children had fewer externalizing problems. In a subsample of mothers with any lifetime substance use at baseline (N=285; 88.5%), children in the intervention group had fewer externalizing and dysregulation problems than those in the standard care group, and fewer scored in the clinically "at risk" range ($10th percentile) for externalizing and internalizing problems. No between-group differences were observed for outcomes measured by the Home Observation for Measurement of the Environment scale. CONCLUSIONS: Outcomes 12 months postpartum suggest that the Family Spirit intervention improves parenting and infant outcomes that predict lower lifetime behavioral and drug use risk for participating teen mothers and children.

Fatherhood roles and drug use among young American Indian men.

BACKGROUND: High rates of substance abuse among young American Indian (AI) fathers pose multigenerational challenges for AI families and communities. OBJECTIVE: The objective of this study was to describe substance use patterns among young AI fathers and examine the intersection of substance use with men's fatherhood roles and responsibilities. METHODS: As part of a home-visiting intervention trial for AI teen mothers and their children, in 2010 we conducted a descriptive study of fatherhood and substance use on three southwestern reservations. Substance use and parenting data were collected from n = 87 male partners of adolescent mothers using audio computer-assisted self-interviews. RESULTS: Male partners were on average 22.9 years old, primarily living with their children (93%), unmarried (87%), and unemployed (70%). Lifetime substance use was high: 80% reported alcohol; 78% marijuana; 34% methamphetamines; 31% crack/cocaine; and 16% reported drinking binge in the past 6 months. Substance use was associated with history of alcohol abuse among participants' fathers (but not mothers); participants' poor relationships with their own fathers; unemployment status; and low involvement in child care. CONCLUSION: Drug and alcohol abuse may be obstructing ideal fatherhood roles among multiple generations of AI males. SCIENTIFIC SIGNIFICANCE: Targeting drug prevention among young AI men during early fatherhood may provide special opportunity to reduce substance use and improve parenting. Intergenerational approaches may hold special promise.

Examining correlates of methamphetamine and other drug use in pregnant American Indian adolescents.

American Indian and Alaska Native (AI/AN) adolescents have high rates of pregnancy, as well as alcohol, marijuana, cocaine, and, increasingly, methamphetamine (meth) use. The progression of adolescent drug use to meth use could have devastating impacts on AI communities, particularly when youth are simultaneously at risk for teen childbearing. In order to inform future prevention efforts, this study explores correlates of meth use in a sample of pregnant AI teens, with a focus on sociodemographic, familial, and cultural factors and use of other drugs.