10/25/2017 - Navajo Nation

1 10/25/20171 Quote from Navajo Nation IRB Chair, Ms. Beverly Pigman (June 27, 2006)1 May all beings be Duran DrPH, Myra Parker, PhDMaya Magarati, PhDUniversity of Washington School of Social WorkDirector, Center for Indigenous Health ResearchIndigenous Wellness Research Nation Research Conference, October 18 19, 20172 Community Engaged Research with Tribal Colleges and Universities:A. Drug and Alcohol Problems and Solutions Study B. Behavioral Wellness Epidemiology StudyC. Adaptation of Brief Alcohol Screening and Intervention for Colleges Students TCU BASICS TCU Drug & Alcohol Problems & Solutions Study Funded by the National Institute of Drug Abuse (NIDA) through the Indian Health Service NARCH program, Grant # 1 R01DA029001 TCU Student ADM Epidemiology StudyFunded by the National Institute on Minority Health and Health Disparities Award #5P60MD006909.

2 TCU Student Brief Alcohol Screening and Intervention for College StudentsFunded by the National Institute of Alcohol Abuse and Alcoholism, Award #5R01AA022068 NIDA: Drug & Alcohol Policy & Organizational Determinants (N=112 students & N=222 faculty & staff) NIMHD: Psychiatric Epidemiology (N = 3,202) NIAAA: Alcohol Harm Reduction Intervention Study (N = 977)10/25/201727 Funded by the National Institute of Drug Abuse (NIDA) through the Indian Health Service NARCH program, Grant # 1 RO1DA029001 Exec. summary 8 37 TCU 85 Sites 16 States 16,629 Native & other students10 CollegeAdvocatePresidentFond du Lac Tribal & CC MinnesotaMs. Shelia SumnerPresident Larry AndersonFort Peck CC MontanaMr. Elijah HopkinsPresident Haven GourneauIlisagvik College AlaskaPresident Pearl Brower President Pearl BrowerInstitute of American Indian Arts New MexicoMs.

3 Greer McSpaddenPresident Robert MartinKeweenaw Bay Ojibwa CC MichiganDr. Lynn AhoPresident Debra J. ParrishLac Courte Oreilles Ojibwa CC WisconsinMr. Dan GretzPresident Diane VertinLittle Priest Tribal College NebraskaMs. Tori Penn KennedyPresident Morgan MaunkaNavajo Technical University New MexicoMs. Delores BecentiPresident Elmer Guy11 CollegeAdvocatePresidentNebraska Indian CC NebraskaMs. Dawne PricePresident Michael OltroggeRed Crow CC AlbertaMr. Henry BigthroatPresident Roy Weasel FatSW Indian Polytechnic Institute New MexicoDr. Cecelia CometsevahPresident Sherry AllisonSaginaw Chippewa Tribal College MichiganMs. Tracy ReedPresident Carla SinewaySitting Bull College South DakotaMs.

4 Melody AzurePresident Laurel VermillionStone Child College MontanaMs. Cory Sangrey BillyPresident Nathaniel St. Pierre*( ; you are sorely missed.)Turtle Mountain CC North DakotaMs. Terri Martin ParisienPresident James Davis12 CollegeAdvocatePresidentBay Mills CC MichiganMs. Kathy AdairPresident Michael C. ParishBlackfeet CC MontanaMr. Brad HallPresident Billie Jo KippDin College ArizonaMs. Marlencia JacksonPresident Monty RoesselNorthwest Indian College WashingtonMs. Victoria RetasketPresident Justin GuilloryOglala Lakota College South DakotaMr. Wayne WestonPresident Thomas ShortBullSalish Kootenai College MontanaMs. Tracie McDonaldPresident Sandra BohamUnited Tribes Technical College North DakotaMs.

5 Stephanie IsaakPresident Russ McDonald10/25/2017313 Exec. summary 14 Establish Partnerships among: Tribal Colleges and Universities (TCU) American Indian Higher Education Consortium (AIHEC) Northwest Indian College (NWIC) Indigenous Wellness Research Institute (IWRI) Develop Community Action Board Math, Science and Technology Chair, Din College Psychology Department Head, Salish Kootenai College Program Director, Research, Evaluation and Dissemination Center, Haskell Indian Nations University Former AIHEC President Retired Lummi Nation tribal elder and Tribal Alcohol and Drug community organizerConduct needs & capacity assessment survey to document: What is know about problematic AOD use Risk, protective factors, and outcomes Best, promising, and current practices Organizational capacity and readiness Dissemi Nation Translating the findings into grant writing, policy and practice Translating the findings into grant writing, policy and practice NIDA Grant #R01DA029001 15 College Variables of Interest Mean (SD)/ N (%)TCU System wide (N=31)1(N, %)Public small very small 2 year Colleges (N=313)p valuesAIAN Faculty595 ( )398 ( )< Age Distribution<2626 3940 and older9768 ( )5804 ( )2693( )359,392 ( )148,496 ( )77,009 ( )< Attending Part time (1 11 units)7022 ( )316,936 ( )< Location 27 ( )149 ( )< Below Poverty in County ( ) ( )< Salary$42,667 (9349)$49,493 (10,733)

6 < of Interest Mean (standard deviation)/ N (%)TCU System wide (N=31)1 Public, small &very small, 2 year Community Colleges (N=313)p valuePercentage of Part time ( ) ( )< of Women ( ) ( )< Grants/Financial Aid per Student2$5,030 (1252)$4,741 (1015) ( ) ( ) ( ) ( ) ( ) ( ) ( ) ( ) < Retention rates (2010)Full Time StudentsPart Time ( ) ( ) ( ) ( )< A 1710%79%12%4%91%5%0%10%20%30%40%50%60%70%80%90%100%NoYesDon't KnowStudent N=112 Faculty Staff N=22818 NIDA Grant # R01DA029001 March 201310/25/2017410%14%46%17%13%8%10%39%22%21%0%5%10%15%20%25%30%35%40%45%50%Drinking is never agood thing to is all rightbut a person shouldnot get gettingdrunk is okay as longas it doesn't interferewith academics orother responsibilitiesOccasionally gettingdrunk is okay even ifit does interfere withacademics or gettingdrunk is okay if that'swhat the individualwants to N=112 Faculty Staff N= 22619 NIDA Grant # R01DA029001 March 20133%22%19%38%15%2%23%21%41%14%0%5%10%15%20%25%30%35%40%45%50%Almostnever/neverSome of thetimeHalf of the time Most of the timeAlmostalways/alwaysStudent N=112

7 Faculty Staff N= 22720 NIDA Grant # R01DA029001 March a representative sample of TCU students and apply a modified Indigenous stress and coping model how AIAN specific risk and protective factors influence alcohol, drug and mental health data collectively for services planning, funding, advocacy2122 Size of SchoolSchoolsTotal Enroll mentAIAN StudentsOnlyN of AIAN Studentsto Recruit1N of Students Needed to Detect 25% PrevalenceTCU BASICS Supplementin 6 TCU2N Students per SchoolVery small (88 300)61082945648 259 N/P24 72 Small (301 500)747522396775310N/P37 58 Medium(501 1000)744323644150332527646 227 Large (1001 2000)5747467905564338188870 784 Total2517740 13775 84891232216433961 Assumes 60% refusal rate; 2N/P Not in BASICS, Of the 6 BASICS participating TCU, 2 are Medium and 4 are Abuse & Mental Health AUDIT for problem drinking screening MINI for suicidality screening Drinking behavior (Life time, past 3 months, past 30 days)

8 Alcohol related problem Drug use and consequences Reasons for drinking Drinking refusal self efficacy Perceived drinking norms Anxiety, Depression, Suicidality, TBI, PTSD, PHQ924 DemographicsEducation Persistence Aspirations Achievement Attainment Barriers Family History10/25/20175 Risk Factors adverse childhood Experiences childhood Trauma Adult Sexual Assault Partner Victimization Everyday Discrimination Financial stress Stigma25 Protective Factors Social Support & Undermining Subjective Happiness Protective Behavioral Strategies Bystander Intervention Victimization Engagement in Non Substance Use Physical ActivitiesRisk Factors Historical trauma Environmental racism Perceived harm of polluted environment26 Protective Factors Resiliency Environmental justice Tribal affiliation Multi ethnic identity TCU social capital Traditional foods Traditional activities Resiliency Native 18 + ONLY AND

9 AIAIN MULTI AND 1: Sample Demographics N = 3,20328 Annual Family Income UNWEIGHTEDWEIGHTED0 - 10, > 10,000 - 25, > 25,000 - 50, > 50,000 As Or Did You Grow Up Mostly On the ALCOHOL USE DIAGNOSIS UNWEIGHTED SevereTotalGenderMale757 ( )111 ( )70 ( ) 100 ( ) 1038 ( )Female1733 ( )207 ( )110 ( ) 115 ( ) 2165 ( )Total (missing = 4)2490 ( )318 ( )180 ( ) 215 ( )3203 2(3) = (p < .0001)Age Group18 21660 ( )85 ( )37 ( ) 55 ( ) 837 ( )22 29838 ( )145 ( )87 ( ) 89 ( ) 1159 ( )30 44652 ( )69 ( )42 ( ) 57 ( ) 820 ( )45+343 ( )19 ( )14 ( ) 14 ( ) 390 ( )Total (missing = 1)2492 ( )318 ( )180 ( ) 215 ( )3206 2(3) = (p < .0001)Race/EthnicityAIAN multi racial2179 ( )281 ( )165 ( ) 210 ( ) 2835 ( )Other298 ( )37 ( )14 ( )5 ( )354 ( )Total(missing = 27)2477 ( )318 ( )179 ( ) 215 ( )3189 2(3) = (p =.)

10 0001)AUD Prevalence by Demographics10/25/2017631 NoneMildModerate SevereTotalAnnual Individual Income ($)0 2,000874 ( )114 ( )63 ( ) 89 ( ) 1140 ( )> 2,000 15,000909 ( )120 ( )72 ( ) 92 ( ) 1193 ( )> 15,000659 ( )76 ( )42 ( ) 31 ( ) 808 ( )Total (missing = 66)2442 ( )310 ( )177 ( ) 212 ( )3141 2(6) = (p = .0108)Marital StatusSingle1325 ( )194 ( )93 ( ) 143 ( ) 1755 ( )Married/living as married1009 ( )110 ( )79 ( ) 60 ( ) 1258 ( )Divorced or separated148 ( )10 ( )5 ( )12 ( )175 ( )Total (missing = 19)2482 ( )314 ( )177 ( ) 215 ( )3188 2(6) = (p = .0002)RegionWoodlands349 ( )45 ( )12 ( ) 19 ( ) 425 ( )Montana/Pacific857 ( )117 ( )76 ( ) 96 ( ) 1146 ( )North/South Dakota678 ( )110 ( )64 ( ) 61 ( ) 913 ( )Southwest610 ( )46 ( )28 ( ) 39 ( ) 723 ( )Total (missing = 0)2494 ( )318 ( )180 ( ) 215 ( ) : Has western science contributed to Indigenous Health Disparities?