Repository logo

Browsing by Author "Emery, Noah, committee member"

Now showing 1 - 2 of 2
  • Thumbnail Image
    ItemOpen Access
    American Indian adolescent methamphetamine use: an examination of region/identity variations and the impact of protective factors
    (Colorado State University. Libraries, 2024) Fredrickson, Gereon J., author; Prince, Mark, advisor; Emery, Noah, committee member; Swaim, Randall, committee member; Zimmerman, Toni, committee member
    Objective: Studies suggest that American Indians (AI) have high rates of methamphetamine use and indicate that AI youth have a significantly higher prevalence of past year methamphetamine use relative to non-Hispanic Whites. Methamphetamine use has been associated with an increased risk of morbidity and many adverse long-term effects. Minimal research explores region and identity differences with methamphetamine use and primarily focuses on risk-factors that lead to higher levels of use. The proposed study sought to identify protective factors that increase abstinence and reduce patterns of use among adolescent AIs by exploring the impact of parental monitoring, positive social/peer support, positive self-esteem, ethnic pride, and ethnic experience on age of initiation and past-year methamphetamine use. Method: This study is a secondary data analysis of survey data collected form an epidemiological research study with AI youth. The current study uses data collected from the Fall of 2015 through the Fall of 2019. Participants included 14,769 adolescents, grades 7-12th, from 103 different schools, across seven distinct regions of the contiguous United States. Analysis Plan: Since lifetime methamphetamine use was reported in only 3.7% of the data, past-year use was dichotomized to account for varying modeling effects and model convergence. Means, frequencies, and standard deviations were calculated for all variables as well as bivariate correlations. To model the protective factors, Structural Equation Modeling (SEM) was used which included testing for model fit and psychometrics of the protective factor scales. An Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were completed to determine fit of the items for each protective factor, with invariance testing at the configural, metric, and scalar levels. Firth's Penalized Likelihood logistic regression and censored regressions were used to examine direct effects between the five protective factors (parental monitoring, positive peer/social influence, self-esteem, ethnic pride, and ethnic experience) and two methamphetamine use outcome variables (i.e., age of initiation and past-year use). Results: Key findings in this study were that males in middle school that identified as AI-multi-ethnic living in the Northeast region and males in high school that identified as AI-multi-ethnic living in the Southern Great Plains region endorsed significantly more methamphetamine use in the past year with an earlier age of initiation. Additionally, parental knowledge, positive peer/social influence, and internal self-esteem increased the likelihood for AI adolescents to have not initiated methamphetamine use. Lastly, parental knowledge, positive peer/social influence, internal and external self-esteem, and ethnic experience factors were significant in increasing the likelihood that AI adolescents did not engage in methamphetamine use in the past year. Conclusions: This study provides powerful recommendations for programs that target AI adolescent methamphetamine use to further prevent initiation and build resilience. It demonstrates the need to foster parental knowledge, positive peer/social influence, self-esteem, and ethnic experience as protective factors. Understanding these factors within the AI community that contribute to positive outcomes for adolescents can help further programs, schools, and communities as prevention strategies implore techniques to maximize effectiveness in reducing overall AI adolescent substance use. Further, these results have implications for future research on prevention of AI adolescent methamphetamine use.
  • Thumbnail Image
    ItemOpen Access
    Substance use, risk, and protective factors among Indigenous youth: an examination of evidence from recent decades
    (Colorado State University. Libraries, 2023) Fetterling, Theodore J., author; Prince, Mark, advisor; Riggs, Nathaniel, committee member; Emery, Noah, committee member; Swaim, Randall, committee member
    American Indian (AI) youth have consistently been identified as an at-risk population for elevated rates of substance use relative to non-AI peers. Reliance upon single-site and regional substance use research with Indigenous samples has led to substantial variability in the magnitude of estimates in the extant literature. This variability is exacerbated by demographic differences shown to influence substance use prevalence as well as the ceremonial use of tobacco in many tribes. Ceremonial practices involving tobacco also present a unique impact on perceptions of availability and harm of substances, however little research has investigated the salience of these perceptions as either risk or protective factors among AI youth. The present study addresses the variability in estimates and limited representation of AI youth by consolidating nearly three decades of repeated cross-sectional data to provide accurate and precise estimates of alcohol, cannabis, and cigarette use. The hypotheses that perceived availability and harm would differentially predict substance use among AI youth compared to White peers were also tested. Method. The sample was drawn from data collected between 1993-2019 as part of ongoing epidemiology research with reservation-dwelling AI youth and White peers. Descriptive statistics were used to provide substance use estimates for alcohol, cannabis, and cigarettes, stratified by race/ethnicity (i.e., AI vs White), grade group, sex, and region. After stratifying for demographic comparisons, estimates were presented for each year of available data and aggregated across years for all substance use variables. Binary logistic and quasi-Poisson regressions were used to test study hypotheses regarding the influence of perceived availability and harm on substance use separately for AI and White youth. A subset of years was selected for an exploratory application of time-varying effect modeling (TVEM) for trend analysis. Results. Similar patterns emerged across demographic comparisons for average cannabis use, showing elevated rates among AI youth relative to White peers. Average lifetime prevalence of cigarettes was consistently higher among AI youth than White peers, however this pattern was not found for average frequency of cigarette use or for any average alcohol use comparison. Hypotheses were partially supported, in that perceived harm was significantly more protective for White youth than for AIs, but perceived availability showed no significant differences in protective influence for lifetime prevalence comparisons of any substance. TVEM trends mirrored descriptive statistic comparisons found for stratification by race/ethnicity and region. Discussion. Findings revealed stark contrasts in rates of substance use and the influences of perceived availability and harm between AI and White youth. These differences are interpreted within the context of historical trauma (HT) and ceremonial practices involving tobacco found in many Indigenous communities. For prevention and intervention programs to be culturally responsive, they should be developed at the community level and incorporate strategies for coping with HT. Additionally, distinguishing recreational tobacco use from ceremonial use can enhance accuracy of estimates in future epidemiology research and contribute to culturally informed prevention and intervention programming for AI youth.