Sandra L. Momper

OxyContin Misuse on a Reservation: Qualitative Reports by American Indians in Talking Circles

Few studies have addressed OxyContin use among American Indians (AIs) on reservations. Eight focus groups were conducted as “talking circles” (2006 and ) with 49 AI adults and youth. An emergent design was utilized in which the initial two circles were planned, but the subsequent six circles evolved from tribal members’ input. Participants reported an increase in OxyContin use; negative effects on individuals, families, and the tribe; a lack of treatment options; and a growing problem on other reservations. Results indicate the need to further research prevalence and patterns of use to design interventions to curtail OxyContin abuse on reservations.

Urban American Indian Adolescent Girls: Framing Sexual Risk Behavior

Purpose: The purpose of this study was to explore factors that influence urban adolescent American Indian (AI) girls’ sexual risk behavior. Design: A qualitative study was conducted with grounded theory methodology to reveal factors and processes that influence sexual risk behavior. Method: Talking circles, individual interviews, and event history calendars were used with 20 urban AI 15- to 19-year-old girls to explore influences on sexual risk behavior. Results: The generated theory—framing sexual risk behavior—describes social and structural factors and processes that influenced the girls’ sexual risk behavior. The theory extends Bronfenbrenner’s ecological model by identifying microsystem, mesosystem, and macrosystem influences on sexual risk behavior. Discussion: Urban AI girls reported similar social and structural influences on sexual risk behavior as urban adolescents from other racial and ethnic groups. However, differences were noted in the family structure, cultural heritage, and unique history of AIs. Implications: This theory can be used in culturally responsive practice with urban AI girls.

Advancing community-based research with urban American Indian populations: multidisciplinary perspectives.

The US has witnessed significant growth among urban American Indian (AI) populations in recent decades, and concerns have been raised that these populations face equal or greater degrees of disadvantage than their reservation counterparts. Surprisingly little urban AI research or community work has been documented in the literature, and even less has been written about the influences of urban settings on community-based work with these populations. Given the deep commitments of community psychology to empowering disadvantaged groups and understanding the impact of contextual factors on the lives of individuals and groups, community psychologists are well suited to fill these gaps in the literature. Toward informing such efforts, this work offers multidisciplinary insights from distinct idiographic accounts of community-based behavioral health research with urban AI populations. Accounts are offered by three researchers and one urban AI community organization staff member, and particular attention is given to issues of community heterogeneity, geography, membership, and collaboration. Each first-person account provides “lessons learned” from the urban context in which the research occurred. Together, these accounts suggest several important areas of consideration in research with urban AIs, some of which also seem relevant to reservation-based work. Finally, the potential role of research as a tool of empowerment for urban AI populations is emphasized, suggesting future research attend to the intersections of identity, sense of community, and empowerment in urban AI populations.

OxyContin Use on a Rural Midwest American Indian Reservation: Demographic Correlates and Reasons for Using

In 2009 we surveyed 400 tribal members of a midwestern American Indian reservation to assess the prevalence of OxyContin use. Thirty percent of tribal participants reported nonmedical use of OxyContin ever, 18.9% in the past year, and 13.4% in the past month. Participants aged 18 to 25 years were most likely to have used OxyContin. Reasons given for use of the drug included pain relief (59.3%) and getting high (52.2%), indicating a need for opioid treatment programs.

“It's Bad Around Here Now”: Tobacco, Alcohol and Other Drug Use Among American Indians Living on a Rural Reservation

Using data about members of a midwestern American Indian reservation in eight focus groups that were conducted like “talking circles,” the authors describe the participants’ (N = 49) views of the current use and abuse of tobacco, alcohol, and other drugs. Results indicate that the use of tobacco is pervasive; that the use of alcohol and other drugs, especially marijuana and oxycodone, are problems on this reservation because they are detrimental to health and well-being; and appropriate, available, and accessible treatment is scarce, nonexistent, or underfunded. Culturally sensitive substance abuse treatment and increased funding for treatment are major health issues for this population.

Service Provider Views of Oxycontin Use on an Indian Reservation: Traumatic Effects on the Tribal Community

This qualitative research study on a Great Lakes Indian reservation used semistructured interviews of American Indian (n = 8) and non-American Indian (n = 2) providers of behavioral and physical health services to elicit views of Oxycontin use. We gathered data on existing substance abuse services including accessibility, cultural appropriateness, service strengths and weaknesses, barriers to treatment, and treatment needs. Results indicated a high prevalence of the use of Oxycontin, with traumatic effects on families and the tribal community such that the providers were overburdened with their dual role as service providers and caretakers in their own community. Implications for social work practice are discussed.

Urban American Indian community perspectives on resources and challenges for youth suicide prevention

American Indian (AI) youth have some of the highest rates of suicide of any group in the United States, and the majority of AI youth live in urban areas away from tribal communities. As such, understanding the resources available for suicide prevention among urban AI youth is critical, as is understanding the challenges involved in accessing such resources. Pre-existing interview data from 15 self-identified AI community members and staff from an Urban Indian Health Organization were examined to understand existing resources for urban AI youth suicide prevention, as well as related challenges. A thematic analysis was undertaken, resulting in three principal themes around suicide prevention: formal resources, informal resources, and community values and beliefs. Formal resources that meet the needs of AI youth were viewed as largely inaccessible or nonexistent, and youth were seen as more likely to seek help from informal sources. Community values of mutual support were thought to reinforce available informal supports. However, challenges arose in terms of the communitys knowledge of and views on discussing suicide, as well as the perceived fit between community values and beliefs and formal prevention models.

Integrating Spiritual and Western Treatment Modalities in a Native American Substance User Center: Provider Perspectives

Few studies examine how traditional Native American and Western healing practices are being integrated in Native American substance user treatment centers. Data are presented from a 2008 study of providers of integrated substance user treatment for Native Americans at an urban Western US center. Nineteen semistructured interviews were conducted to examine 10 providers’ views of the integration of traditional and Western healing and the impact on recovery for clients. We used a grounded theory approach to data analysis with manual and NVivo codes and themes developed. Limitations and implications for practice are discussed.

American Indian elders share personal stories of alcohol use with younger tribal members

ABSTRACT In this Great Lakes Indian reservation qualitative study we utilized focus groups in the form of talking circles to elicit tribal members’ views of alcohol use. We report on how the elder participants utilized the talking circles to inform the youth of the deleterious effects of alcohol use and abuse. Indigenous research methods were utilized so elder tribal members were consulted about the study; an elder was hired as a research associate; youth were hired as note takers/observers; and the 2-hour groups were led by a tribal community member. Demographic data were gathered, and a semistructured guide with substance use questions was utilized. Tribal members, 30 females and 19 males, age 12 to 78 participated in 8 talking circles (N = 49). Tribal elders unexpectedly utilized the format as an opportunity for cross-generational storytelling to convey their own oral histories of the harmful effects of alcohol use for the younger participants. They shared personal pathways to quitting or to a reduction in drinking with messages aimed at preventing the youth from initiating drinking. A shortage of American Indian (AI) substance abuse treatment programs that are culturally relevant exists. The widespread and renewed use of cross-generational talking circles could serve as an inexpensive substance abuse prevention and intervention treatment modality for AI youth. The elders’ stories highlight the need to rejuvenate traditional methods of healing among AIs to reduce the initiation and/or harmful effects of overuse of alcohol among AI youth.

An urban American Indian health clinic's response to a community needs assessment.

Utilizing community-based methods, we assessed the behavioral and physical health needs of a Detroit metropolitan Indian health clinic. The project goal was to identify health service needs for urban American Indians/Alaska Natives and develop the infrastructure for culturally competent and integrative behavioral and physical health care. We conducted 38 semi-structured interviews and 12 focus groups with service providers and community members. Interview and focus group data indicated a need for 1) more culturally competent services and providers, 2) more specialized health services, and 3) more transportation options. We then report on the Indian health clinics and communitys accomplishments in response to the needs assessment.