Publications by Colleges and Departments (MSU - Bozeman)
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Item Association of racism and substance use treatment with belief in the myth of an American Indian/Alaska Native biological vulnerability to alcohol problems(American Psychological Association, 2023-06) Gonzalez, Vivian M.; Skewes, Monica C.Objectives: Belief in an American Indian/Alaska Native (AIAN) specific biological vulnerability (BV) to alcohol problems is associated with worse alcohol outcomes among AIANs. Despite a notable lack of evidence that biogenetic factors play a greater role in the development of alcohol problems among AIANs than other groups, many people still believe this myth. Consistent with theory and evidence that greater experiences with discrimination leads to the internalization of stereotypes and oppression, we hypothesized that greater perceived racial discrimination (racism) would be associated with greater BV belief, but that having a stronger ethnic identity would weaken this association. We also examined whether previous substance use treatment as well as participation in Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) was associated with BV belief. Method: Participants were 198 reservation-dwelling AI adults with a substance use problem who completed a survey as part of a larger community-based participatory study. Results: A multiple regression analysis revealed that greater systemic racism was associated with greater belief in a BV; this association was not moderated by ethnic identity. Greater interpersonal racism was also associated with greater BV belief—but only among those low in ethnic identity. A regression analysis revealed that previous treatment, AA, and NA participation were not associated with BV belief. Conclusions: Greater systemic and interpersonal racism were associated with belief in a BV, and greater ethnic identity buffered the association between interpersonal racism and BV belief. This suggests that both combatting racism and fostering positive ethnic identity may help to lessen BV belief. (PsycInfo Database Record (c) 2023 APA, all rights reserved)Item Development and Feasibility Pilot Study of Indigenous Recovery Planning: A Community-Engaged Approach to Addressing Substance Use in a Native Community(SAGE Publications, 2023-02) Skewes, Monica C.; Gonzalez, Vivian M.; Gameon, Julie A.; Ricker, Adriann; Martell, Shannon; Reum, Martel; Holder, ShannonAlthough Native (American Indian [AI] and Alaska Native [AN]) populations have high rates of abstinence from alcohol, health problems associated with substance use remain a pressing concern in many AI/AN communities. As part of a longstanding community-based participatory research project involving 5 years of relationship building and three preliminary studies, our team of academic and community coresearchers developed a culturally grounded intervention to facilitate recovery from substance use disorders among tribal members from a rural AI reservation. Our Indigenous Recovery Planning (IRP) intervention consists of six weekly sessions and is designed to provide inroads to existing resources in the community, affirm and enhance Native identity, address culturally relevant risk factors, and build on strengths. Results from a feasibility pilot study (N = 15) suggest that IRP is feasible to implement and acceptable to the community. Although there was insufficient statistical power to conduct hypothesis testing, there were changes between pretest and posttest scores in the expected directions. Future directions and limitations of this research are discussed.Item Belief in the myth of an American Indian/Alaska Native biological vulnerability to alcohol problems among reservation‐dwelling participants with a substance use problem(Wiley, 2021-11) Gonzalez, Vivian M.; Skewes, Monica C.Belief in the myth of an American Indian/Alaska Native (AIAN) specific biological vulnerability (BV) to alcohol problems is associated with worse alcohol outcomes among AIAN college students who drink, despite also being associated with greater attempts to reduce drinking. This study examined the association of belief in a BV with alcohol use among reservation-dwelling AI adults with a substance use problem. Methods: Participants (n=141) who drank alcohol in the past 90 days were selected from a larger AI sample who self-identified as having a substance use problem. Moderated-mediation analyses examined whether belief in a BV was positively associated with alcohol use and substance use consequences, as well as whether self-efficacy and craving mediated the association of belief in a BV with alcohol use. Results: Among participants who reported using alcohol but not hard drugs (e.g., methamphetamine, opioids), greater belief in a BV was associated with greater drinking days, which in turn was associated with greater consequences. Among participants who used alcohol only, belief in a BV was also significantly associated with greater craving, and in turn with greater drinking days. Among those who used both alcohol and hard drugs, greater belief in a BV was associated with fewer drinking days, but was not significantly associated with consequences. No association was found between belief in a BV and self-efficacy to avoid alcohol or drug use. Conclusions: Among those who use only alcohol, belief in a BV may contribute to greater drinking days and consequences through its association with greater craving. This study provides further evidence of the potential harm of internalizing the belief that being AIAN contributes to risk for alcohol problems, a notion that lacks scientific evidence despite decades of research. The findings highlight the importance of combating societal myths regarding AIAN peoples and the internalization of these stereotypes.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 Beliefs about causal factors for suicide in rural Alaska Native communities and recommendations for prevention(SAGE Publications, 2020-11) Skewes, Monica C.; Gameon, Julie A.; Grubin, Fiona; DeCou, Christopher R.; Whitcomb, LindseyRural Indigenous communities in Alaska suffer staggeringly high rates of suicide. In close-knit Alaska Native villages, each suicide leaves a trail of affected family and community members in its wake. This research aimed to understand community perceptions of what causes suicide in rural Alaska Native villages and generate recommendations for prevention strategies. In-depth interviews were conducted with 25 Alaska Native university students who moved from rural villages to an urban area to attend college. All had been profoundly affected by others’ suicides and shared their beliefs about causal factors and recommendations for prevention efforts. Perceived causes included resistance to seeking help or discussing personal problems, loss of culture, traumatic experiences, geographical and social isolation, lack of opportunity, substance abuse, and exposure to others’ suicides. Participants believed that suicide is preventable and recommended multi-level approaches to address suicide disparities. They provided recommendations for potentially effective and culturally appropriate prevention strategies, including increasing cultural and social connections, educating community members about mental health, and increasing accessibility of counseling services/reducing barriers to mental health services utilization.Item Health Disparities Research with American Indian Communities: The Importance of Trust and Transparency(2021) Skewes, Monica C.; Gonzalez, Vivian M.; Gameon, Julie A.; FireMoon, Paula; Salois, Emily; Rasmus, Stacy M.; Lewis, Jordan P.; Gardner, Scott A.; Ricker, Adriann; Reum, MartelAmerican Indian and Alaska Native (AI/AN) communities experience notable health disparities associated with substance use, including disproportionate rates of accidents/injuries, diabetes, liver disease, suicide, and substance use disorders. Effective treatments for substance use are needed to improve health equity for AI/AN communities. However, an unfortunate history of unethical and stigmatizing research has engendered distrust and reluctance to participate in research among many Native communities. In recent years, researchers have made progress toward engaging in ethical health disparities research by using a community-based participatory research (CBPR) framework to work in close partnership with community members throughout the research process. In this methodological process paper, we discuss the collaborative development of a quantitative survey aimed at understanding risk and protective factors for substance use among a sample of tribal members residing on a rural AI reservation with numerous systems-level barriers to recovery and limited access to treatment. By using a CBPR approach and prioritizing trust and transparency with community partners and participants, we were able to successfully recruit our target sample and collect quality data from nearly 200 tribal members who self-identified as having a substance use problem. Strategies for enhancing buy-in and recruiting a community sample are discussed.Item Belief in the American Indian/Alaska Native biological vulnerability myth and drinking to cope: Does stereotype threat play a role?(2021-01) Gonzalez, Vivian M.; Burroughs, Adrienne; Skewes, Monica C.Objectives: The effects of stereotype threat and internalized alcohol stereotypes on negative affect and negative affect-related drinking have not been examined in American Indians/Alaska Natives (AI/ANs), despite their frequently being subjected to alcohol stereotypes. The current study examined the association of belief in the myth of an AI/AN specific biological vulnerability (BV) with alcohol consequences through its effect on depression and drinking to cope with negative affect. Method: In this cross-sectional study, a moderated mediation model examined the association of belief in a BV with alcohol consequences via sequential mediators of depression and drinking to cope. It was hypothesized that the positive association of belief in a BV with depression would be stronger among individuals who engaged in more frequent heavy episodic drinking. Participants were 109 female (69.9%) and 47 male (30.1%) AI/AN college students (Mage = 27.1 years, range 18 to 61) who reported having at least 1 drink in the past month. Results: Belief in a BV was positively associated with depression symptoms among participants reporting average or high frequency of heavy episodic drinking. Greater depression symptoms predicted greater drinking to cope, which in turn predicted greater alcohol consequences. Conclusion: Belief in the BV myth may act as a type of stereotype threat, contributing to alcohol consequences by increasing negative affect and drinking to cope. These results suggest that for AI/ANs who drink, there are psychological and behavioral health ramifications of believing in the notion of a BV, and a need to debunk this myth.Item Absent autonomy: Relational competence and gendered paths to faculty self-determination in the promotion and tenure process(2018-09) Skewes, Monica C.; Shanahan, Elizabeth A.; Smith, Jessi L.; Honea, Joy C.; Belou, Rebecca M.; Rushing, Sara; Intemann, Kristen; Handley, Ian M.This research examines ways in which men and women university faculty sought self-determination in the promotion and tenure (P&T) process. Self-Determination Theory (SDT; Deci & Ryan, 2012) research tends to view autonomy as the central factor in self-determination, taking priority over other psychological needs of relatedness and competence. The P&T process occurs within a context that inherently limits autonomy, providing a unique opportunity to examine experiences of relatedness and competence when autonomy is constrained. We used a qualitative research strategy with a matched case study design to explore how individuals experience the constructs of SDT (i.e., autonomy, competence, and relatedness) within the P&T process. Our project focuses on faculty in science, technology, engineering, and mathematics (STEM) departments undergoing P&T review at one university. Women faculty in STEM were compared with men faculty at the same rank and in similar departments concurrently going through P&T review. Findings showed that men reported experiencing self-determination via informational competence whereas women approached self-determination through relational competence. Creating a level playing field for faculty navigating the P&T process requires being attuned to different paths to self-determination, fostering relationships between faculty, and clarifying policies and procedures.Item Association of belief in the "firewater myth" with strategies to avoid alcohol consequences among American Indian and Alaska Native college students who drink(2018-05) Gonzalez, Vivian M.; Skewes, Monica C.Belief in an American Indian/Alaska Native (AI/AN) specific biological vulnerability (BV) to alcohol problems (aka the "firewater myth") is associated with worse alcohol outcomes among AI/AN college students who drink, despite also being associated with greater attempts to reduce drinking. The current study examined how belief in a BV may have affected how 157 AI/AN college students who drink (a) attempted to moderate their alcohol use and avoid alcohol-related problems using abstinence-based and harm reduction strategies, and (b) attitudes toward these strategies as a means of addressing alcohol problems. Contrary to our hypotheses, belief in a BV was not found to be associated with use of harm reduction strategies or with how effective students believed these strategies to be. However, greater belief in a BV was associated with lower self-efficacy for the use of harm reduction strategies among more frequent heavy episodic drinkers. This is concerning, as the use of harm reduction strategies was associated with less frequent heavy episodic drinking in this sample. In contrast, belief in a BV was positively associated with the use of abstinence-based strategies and with how effective these strategies were perceived to be. However, for individuals with average or greater belief in a BV, abstinence-based strategies were associated with greater alcohol consequences. The results suggest that for AI/AN students who drink, belief in a BV may be influencing the strategies used to moderate alcohol use and avoid alcohol-related harm, as well as attitudes toward these strategies, in ways that do not appear helpful.Item A preliminary needs assessment of American Indians who inject drugs in northeastern Montana(2017-05) Anastario, Mike; FourStar, Kris; Ricker, Adriann; Dick, Rebecca; Skewes, Monica C.; Rink, ElizabethBACKGROUND Injection drug use has not been well documented in American Indians living in the USA. American Indian and Alaskan Natives (AI/ANs) show higher rates of substance use compared to the general population, and have historically been subject to a number of risk factors that are known to increase the likelihood of substance use. AI/ANs also experience increased risk for infectious diseases that are transmitted via injection drug use and/or sexual activity. Harm reduction approaches have been shown to be effective for decreasing risk of disease transmission in at-risk populations, and may be well suited for AI/AN injection drug users residing in rural reservation communities. In this study, we aimed to examine the characteristics of American Indians (AI) who use injection drugs (PWUID) in northeastern Montana to identify needs that could be addressed with harm reduction programming. METHODS For the present study, we used a respondent-driven sampling approach to generate a sample of 51 self-identified male and female injection drug users ≥18 years of age who were American Indians living on the Fort Peck Indian Reservation. Sampling weights were applied to all analyses using Respondent-Driven Sampling Analysis Tool (RDSAT). RESULTS There were no strong recruitment patterns by age, sex, or ethnic identity status of the recruiter or participant, but there were strong within-group recruitment patterns by location within the reservation. The majority of the sample reported initiating substance use before the age of 18. Participants reported significant risk for HIV, hepatitis, and other infectious diseases through their drug use and/or risky sexual behavior. Sixty-five percent reported having reused syringes, and 53% reported drawing from the same filter. Seventy-five percent reported inconsistent condom use during the 3 months preceding the survey, and 53% reported injecting drugs during sex during the 3 months preceding the survey. Only 66% of participants reported having been tested for HIV in the 12 months preceding the survey. The vast majority (98%) of respondents expressed interest in a harm reduction program. Seventy-six percent reported that it was easy or very easy to obtain new syringes. CONCLUSIONS We documented several risks for blood-borne pathogens, including elevated levels of syringe reuse. Further, we documented significant interest in harm reduction interventions in the present sample of AI/AN injection drug users. Findings suggest a need for increased access to harm reduction programming for AI/AN injection drug users to reduce the transmission of infectious disease and increase access to compassionate care.