Publications by Colleges and Departments (MSU - Bozeman)
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Item Determinants of Relapse and Opportunities for Growth: Perspectives on Substance Use among American Indian Community Members(Informa UK Limited, 2021-10) Skewes, Monica C.; Gameon, Julie A.; Hallum-Montes, Rachel; Ricker, Adriannesulting from generations of historical oppression and systemic racism, American Indian and Alaska Native (AI/AN) communities experience serious health disparities associated with substance use disorders (SUDs). As part of a longstanding community-based participatory research intervention development project, our partnership of academic and community co-researchers conducted seven focus groups (N = 35) to understand community stakeholders’ perspectives on substance use, relapse, and recovery on a rural AI reservation. Participants included cultural leaders (n = 10), SUD treatment providers (n = 5), people with SUD (n = 10), and affected family members (n = 10). Cultural leaders viewed relapse as symptomatic of historical oppression, whereas other stakeholder groups attributed relapse to individual and interpersonal risk factors such as peer influence, lack of family support, and traumatic stress. All participant groups recognized relapse as a normative aspect of recovering from SUD that presents new opportunities for learning and growth. Specifically, regaining humility, learning to ask for help, recognizing one’s triggers, and strengthening commitment to change were identified as learning outcomes for people with SUD. For family members, relapse provided the opportunity to practice forgiveness and compassion, two important cultural values. All groups emphasized the importance of grounding interventions in cultural values and traditions.Item Determinants of transgender individuals' well-being, mental health, and suicidality in a rural state(2018-04) Smith, Adina J.; Hallum-Montes, Rachel; Nevin, Kyndra; Zenker, Roberta; Sutherland, Bree; Reagor, Shawn; Orti, M. Elizabeth; Woods, Catherine A.; Frost, Melissa; Cochran, Bryan N.; Oost, Kathryn M.; Gleason, Hillary; Brennan, James M.This project utilized a Community-Based Participatory Research (CBPR) approach to conduct qualitative interviews with 30 transgender adults living in a rural state. Participants' identities spanned from trans women and men to nonbinary and Two-Spirit. The aim of this study was to better understand the experiences, needs, and priorities of the participants as well as to examine possible determinants of mental health, well-being, and suicidality for transgender individuals in Montana. These factors were investigated at individual, interpersonal, community, and societal levels using an ecological framework. Qualitative results indicate that participants experienced discrimination at all levels. Participants noted that discrimination contributed to mental health challenges and limited access to adequate general and transgender-specific health care services, both of which impacted overall well-being. This is reflected most notably in the elevated rate of past suicidal ideation attempts among the sample. Participants reported that the ability to transition, as well as other protective factors, played a role in reducing suicidality and improving mental and physical health. Our findings highlight the need to address transgender mental health through implementing changes at multiple ecological levels.