American Indian adolescent methamphetamine use: an examination of region/identity variations and the impact of protective factors
Date
2024
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Abstract
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.