Young Adult Migration from a Northern Plains Indian Reservation: Who Stays and Who Leaves.

We evaluated how ambitions, community ties, monetary sufficiency, employment, and alcohol consumption related to whether young American Indian adults had moved from their Northern Plains reservation. Of 518 Northern Plains reservation residents in 1993, we located 472 in 2003-2005 and found that 89 lived more than a four-hour drive from the reservation. Coding the 472 as to whether they had stayed on/near the reservation or moved away, we ran logistic regressions on data they reported in 1996 to determine which demographic and attitudinal variables were associated with having moved. We found ambitions and goals were more associated with moving away than were ties to the community, which in turn were more related than monetary and personal characteristics that promote independence and prosperity. The more importance they placed on getting a good education or carrying on the tribe's traditions, the more likely they were to have moved away. We found too that the odds of moving away decreased with greater alcohol consumption. Tribal council members and college administrators therefore may wish to promote policies that increase opportunities for young adults to achieve higher education goals while remaining on reservation to carry on tribal traditions. Benefits may also come from encouraging and assisting reservation members studying off-reservation to return after completing their education. These findings would argue too for greater investment in alcohol services for reservation-dwelling populations.

A program of research on spirituality and American Indian alcohol use.

In this brief report we summarize a pattern of findings that has emerged from our research on American Indian (AI) alcohol use and spirituality. With funds from the National Institute of Alcohol Abuse and Alcoholism and the Fetzer Institute (AA 13 053; P. Spicer, PI) we have used both epidemiologic and ethnographic methods to develop a more complete understanding of the role that spirituality and religion play in changes in drinking behavior among AIs. We begin by first situating the importance of research on spirituality in the more general literature on the AI experience with alcohol before highlighting our published findings in this area. We then close with some speculation about possible next steps in this research program to address what remains one of the most compelling sources of health disparities in the first nations of the United States.

Attitudes of urban American Indians and Alaska Natives regarding participation in research.

OBJECTIVE: To determine what factors influence participation in health research among American Indians and Alaska Natives. METHODS: Using vignettes that described 3 types of research studies (a behavioral intervention trial, a genetic association study, and a pharmacotherapy trial), we surveyed 319 patients and 101 staff from an urban Indian health care facility to ascertain how study design, institutional sponsorship, community involvement, human subjects' issues, and subject matter influence participation. RESULTS: Overall response rates were 93% for patients and 75% for staff. Hypothetical participation was highest for the genetic study (patients=64%; staff=48%), followed by the behavioral intervention (patients=46%; staff=42%), and the pharmacotherapy trial (patients=32%; staff=23%). The odds of participation (odds ratio [OR]) were generally increased among patients and staff when the study was conducted by health care providers (OR=1.3 to 2.9) and addressed serious health problems (OR=1.2 to 7.2), but were decreased if the federal government led the study (OR=0.3 to 0.5), confidentiality might be broken (OR=0.1 to 0.3), and compensation was not provided (OR=0.5 to 0.7). CONCLUSION: Close attention to study type, institutional sponsorship, community involvement, potential risks and benefits, and topic are essential to conceptualizing, designing, and implementing successful health research with American Indian and Alaska Native populations.

Documenting natural recovery in American-Indian drinking behavior: a coding scheme.

OBJECTIVE: This report describes a coding scheme developed to analyze how some American Indians changed their drinking behavior and explores the contributions of this approach to our understanding of natural recovery in American-Indian communities. METHOD: We analyzed the responses to two open-ended questions about drinking in an epidemiological survey. The first question asked what helped respondents to quit or cut down on their drinking; the second asked respondents what they did instead of drinking when they wanted to drink. Codes were developed using anthropological analyses of content and then refined through analyses of frequencies and attempts to establish reliability. The frequencies of these codes were then examined by gender, age and current drinking status. RESULTS: Reliability was attained for the coding of responses to both questions. Their content reflects salient themes in the literature on natural recovery. The distribution of these codes across gender, age and current drinking status reveals interesting insights into what prompts and supports quitting and change for different members of these American-Indian communities, especially for women, older respondents and those who abstain from alcohol. CONCLUSIONS: This approach points the way to a consideration of a broad set of factors related to changes in drinking behavior in American-Indian populations that can be applied in future studies, both in American-Indian communities and, potentially, in other populations as well.