Potentially Traumatic Events of Women of Color in an Urban Adult Basic Education Program.

Adult Basic Education (ABE) in the United States is an important tool for underrepresented and underserved communities to achieve the goal of high school graduation following noncompletion of K-12 education. Largely in urban settings, ABE centers serve millions of students annually, especially historically and contemporarily marginalized groups. ABE provides critical resources and skills to meet the educational needs of diverse peoples seeking to advance their station in life. ABE centers may serve students with potentially traumatic events (PTE), diagnosable trauma, and related poorer outcomes. Alarmingly, a paucity of research exists that examines the presence of PTEs for ABE students, particularly people and women of color. In the present research, the Patient Health Questionnaire 9-item and Generalized Anxiety Disorder 7-item measures were used to weigh depression and anxiety scores across the Life Events Checklist for the DSM-5 (LEC-5) trauma types in a sample (N=170) of predominantly women of color. We examined three respondent groups based on proximity and frequency of PTEs: (1) denied; (2) witnessed/learned about; and (3) experienced. Results indicate that those experiencing higher levels of PTEs (namely, sexual assault, unwanted/uncomfortable sexual experience, and sudden accidental death) also experienced higher ratings of depression and anxiety. More research is indicated, as women of color within ABE settings could benefit from tailored resources for prevention, intervention, and treatment.

Indigenous Elder-centered methodology: research that decolonizes and indigenizes.

Indigenous research posits that practice-based evidence is fundamental to culturally grounded, multifaceted methods. The objective is to outline the key tenets and characteristics of Elder-centered research and relevant methodology using an interconnected progression of Alaska Native studies. Semi-structured interviews were conducted with 12 Alaska Native Elders, 21 Alaska Native caregivers, and 12 Alaska Native and non-Native caregivers in two studies exploring cultural understandings of memory and successful aging. The design and implementation of these studies employed Elders at every level, ensuring cultural relevance, outcomes, and dissemination. Results reflect the benefits of engaging Alaska Native Elders in research and reveal methods for best practices: (a) creating advisory councils, (b) identifying stakeholders, (c) weaving together Elder and western knowledge systems, and (d) the reciprocal nature of Elder engagement and well-being. This research centers Indigenous values and research for an Elder-centered methodology that encourages engagement of older adults in applicable, meaningful, restorative, and enculturated ways.

Lessons learned and future directions: A scoping review of American Indian and Alaska Native participants in the National Drug Abuse Treatment Clinical Trials Network.

INTRODUCTION: American Indian and Alaska Native (AI/AN) populations are disproportionately affected by substance use disorders (SUDs) and related health disparities in contrast to other ethnoracial groups in the United States. Over the past 20 years, substantial resources have been allocated to the National Institute on Drug Abuse Clinical Trials Network (CTN) to disseminate and implement effective SUD treatments in communities. However, we know little about how these resources have benefitted AI/AN peoples with SUD who arguably experience the greatest burden of SUDs. This review aims to determine lessons learned about AI/AN substance use and treatment outcomes in the CTN and the role of racism and Tribal identity. METHOD: We conducted a scoping review informed by the Joanna Briggs framework and PRISMA Extension for Scoping Reviews checklist and explanation. The study team conducted the search strategy within the CTN Dissemination Library and nine additional databases for articles published between 2000 and 2021. The review included studies if they reported results for AI/AN participants. Two reviewers determined study eligibility. RESULTS: A systematic search yielded 13 empirical articles and six conceptual articles. Themes from the 13 empirical articles included: (1) Tribal Identity: Race, Culture, and Discrimination; (2) Treatment Engagement: Access and Retention; (3) Comorbid Conditions; (4) HIV/Risky Sexual Behaviors; and (5) Dissemination. The most salient theme was Tribal Identity: Race, Culture, and Discrimination, which was present in all articles that included a primary AI/AN sample (k = 8). Themes assessed but not identified for AI/AN peoples were Harm Reduction, Measurement Equivalence, Pharmacotherapy, and Substance Use Outcomes. The conceptual contributions used AI/AN CTN studies as exemplars of community-based and Tribal participatory research (CBPR/TPR). CONCLUSION: CTN studies conducted with AI/AN communities demonstrate culturally congruent methods, including CBPR/TPR strategies; consideration/assessment of cultural identity, racism, and discrimination; and CBPR/TPR informed dissemination plans. Although important efforts are underway to increase AI/AN participation in the CTN, future research would benefit from strategies to increase participation of this population. Such strategies include reporting AI/AN subgroup data; addressing issues of cultural identity and experiences of racism; and adopting an overall effort for research aimed at understanding barriers to treatment access, engagement, utilization, retention, and outcomes for both treatment and research disparities for AI/AN populations.

Investigating the associations of acute psychedelic experiences and changes in racial trauma symptoms, psychological flexibility, and substance use among People with Racial and Ethnic Minoritized Identities in the United States and Canada.

INTRODUCTION: Evidence suggests that psychedelics may serve as a therapeutic approach to reduce substance use; however, people with racial and ethnic minoritized (REM) identities are often excluded from this research. We investigated whether psychedelic use affects other substance use among REM people and whether perceived changes in psychological flexibility and racial trauma mediates this association. METHODS: REM people in the United States and Canada (N = 211; 32 % Black, 29 % Asian, 18 % American Indian/Indigenous Canadian, 21 % Native Hawaiian/Pacific Islander; 57 % female; mean age = 33.1, SD = 11.2) completed an online survey retrospectively reporting their substance use, psychological flexibility, and racial trauma symptoms 30 days before and after their most memorable psychedelic experience. RESULTS: Analyses showed a significant perceived reduction in alcohol (p < .0001, d = 0.54) and drug use (p = .0001, d = 0.23) from before to after the psychedelic experience. Preliminary associations found perceived reductions in racial trauma symptoms were associated with perceived reductions in alcohol use and this association varied by race, dose, ethnic identity, and change in depressive symptoms. Specifically, Indigenous participants experienced greater perceived reductions in alcohol use relative to participants who identified as Asian, Black, or other. Those who took a high dose of psychedelics experienced greater perceived reductions in alcohol use relative to those who took a low dose. Participants with a stronger ethnic identity and those with a perceived reduction in depressive symptoms experienced a perceived reduction in alcohol use. Serial mediation indicated a perceived increase in psychological flexibility and reduction in racial trauma symptoms mediated the association between acute psychedelic effects and perceived reductions in alcohol and drug use. CONCLUSION: These findings suggest that psychedelic experiences may contribute to an increase in psychological flexibility and reduction in racial trauma symptoms and alcohol and drug use among REM people. REM people have been largely excluded from psychedelic treatment research even though psychedelic use is considered a traditional healing practice in many communities of color. Longitudinal studies of REM people should replicate our findings.

Dementia, Substance Misuse, and Social Determinants of Health: American Indian and Alaska Native Peoples' Prevention, Service, and Care.

Background: American Indian and Alaska Native (AI/AN) peoples are disproportionately impacted by substance use disorders (SUDs) and health consequences in contrast to all racial/ethnic groups in the United States. This is alarming that AI/AN peoples experience significant health disparities and disease burden that are exacerbated by settler-colonial traumas expressed through prejudice, stigma, discrimination, and systemic and structural inequities. One such compounding disease for AI/AN peoples that is expected to increase but little is known is Alzheimer's disease and related dementias (ADRD). AI/AN approaches for understanding and treating disease have long been rooted in culture, context, and worldview. Thus, culturally based prevention, service, and caregiving are critical to optimal outcomes, and investigating cultural beliefs regarding ADRD can provide insights into linkages of chronic stressors, disease, prevention and treatment, and the role of substance misuse. Method: To understand the cultural practices and values that compose AI/AN Elder beliefs and perceptions of ADRD, a grounded theory, qualitative study was conducted. Twelve semistructured interviews with AI/AN Elders (M age = 73; female = 8, male = 4) assessed the etiology, course, treatment, caregiving, and the culturally derived meanings of ADRD, which provides a frame of understanding social determinants of health (SDH; eg, healthcare equity, community context) and impacts (eg, historical trauma, substance misuse) across the lifespan. Results: Qualitative analyses specific to disease etiology, barriers to treatment, and SDH revealed 6 interrelated and nested subthemes elucidating both the resilience and the chronic stressors and barriers faced by AI/AN peoples that directly impact prevention, disease progression, and related services: (1) postcolonial distress; (2) substance misuse; (3) distrust of Western medicine; (4) structural inequities; (5) walking in two worlds; and (6) decolonizing and indigenizing medicine. Conclusion: Barriers to optimal wellbeing and SDH for AI/AN peoples are understood through SUDs, ADRD, and compounding symptoms upheld by colonial traumas and postcolonial distress. En masse historical and contemporary discrimination and stress, particularly within Western medicine, both contextualizes the present and points to the ways in which the strengths, wisdom, and balance inherent in AI/AN culture are imperative to the holistic health and healing of AI/AN peoples, families, and communities.

Endorsement of the "firewater myth" affects the use of protective behavioral strategies among American Indian and Alaska Native students.

Belief in an American Indian/Alaska Native (AI/AN) specific biological vulnerability (BV) to alcohol problems (aka the "firewater myth") has been found to be associated with worse alcohol outcomes among AI/AN college students who drink, despite also being associated with greater attempts to reduce drinking. In the current study, we examined the associations of belief in a BV and belief that AI/AN people have more alcohol problems with the use of alcohol protective behavioral strategies (PBS) among AI/AN college students. PBS examined, as measured by the Protective Behavioral Strategies Scale-20, included manner of drinking, limiting/stopping drinking, and serious harm reduction strategies. Participants were college students who identified being AI/AN (n = 137) and had drank in the past month, and were selected from a larger multi-site study on PBS. Mediation models revealed that greater belief in a BV and belief that AI/AN people have more alcohol problems were both negatively associated with manner of drinking, which in turn was associated with greater past month alcohol use and alcohol consequences. These beliefs were not significantly associated with other PBS. Consistent with prior research with other student populations, both manner of drinking and limiting/stopping drinking were associated with less alcohol use and all three domains of PBS were directly associated with fewer alcohol consequences. The results suggest that these beliefs regarding AI/AN people and alcohol negatively affect the use of strategies aimed at avoiding drinking behavior that can lead to rapid drinking and a higher blood alcohol content, contributing to alcohol consequences.