Cultural adaptation, psychometric properties, and outcomes of the Native American Spirituality Scale.

Abstract

Spirituality is central to many Native Americans (NAs) and has been associated with recovery from substance use disorders (SUDs). However, no published questionnaire uniquely taps tribal-specific spiritual beliefs and practices. This hinders efforts to integrate traditional NA spirituality into SUD treatment and track spiritual outcomes. As part of a randomized controlled trial examining SUD treatment for NAs, we adapted the Daily Spiritual Experience Scale (DSES) in collaboration with members of a Southwest tribe to create the Native American Spirituality Scale (NASS) and measured changes in the NASS over the course of treatment. The 83 participants (70% male) were from a single Southwest tribe and seeking SUD treatment. They completed the NASS at baseline, four-, eight-, and 12-months. Exploratory factor analysis of the NASS was conducted and its temporal invariance, construct validity, and longitudinal changes in the factor and item scores were examined. The NASS yielded a two-factor structure that was largely invariant across time. Factor 1 reflected behavioral practices, while Factor 2 reflected more global beliefs. Both factors significantly increased across 12 months, albeit at different assessment points. At baseline, Factor 1 was negatively related to substance use and positively associated with measures of tribal identification while Factor 2 was unrelated to these measures. Given the importance of tribal spirituality to many NAs, the development of this psychometrically sound measure is a key precursor and complement to the incorporation of tribal spirituality into treatment, as well as research on mechanisms of change for SUD treatment among NAs and assessment of NA spirituality in relation to other aspects of health.

Partnering with Native Communities to Develop a Culturally Grounded Intervention for Substance Use Disorder

“…Therefore, we cannot assume these findings will generalize to other members of the community or to other Native communities or cultures. However, as many of the findings from this study (e.g., the importance of spirituality among AI/ANs; Greenfield et al., ) have been reported previously in the literature, we are confident that the findings do accurately represent the perspectives of many community members and contend that this research constituted a necessary and valuable first step toward our current intervention development work and future research endeavors.…”

Religious and Spiritual Practices Among Homeless Urban American Indians and Alaska Natives with Severe Alcohol Problems

“…Participants’ responses, however, may have been shaped by the manner in which the questions were delivered. For example, AI/AN participants might not have assumed that questions about “religious or spiritual services,” which may have connoted attending church or synagogue services, were inclusive of Native religious ceremonies or spiritual events (see Greenfield et al, 2015). Most measures of religiosity and spirituality, including the one used in the current study, have not been validated for use with AI/ANs, and culturally-adapted assessment of these constructs for AI/ANs has been indicated (Greenfield et al, 2015).…”

“…Further, prior research has indicated that many urban AI/ANs are interested in Native religious and spiritual practices but are unable to access them (Clifasefi, Collins, Torres, Grazioli, & Mackelprang, 2016; Hartmann & Gone, 2012). Considering that religious and spiritual practices have a protective effect in the general population (Greenfield et al, 2015), we recommend that researchers and providers assess the importance and potential clinical significance of Native practices and, when appropriate, help to connect AI/ANs with opportunities to engage in them.…”

“…In other words, individuals who are more engaged in their own cultural identity and cultural practices tend to consume less alcohol and experience reduced alcohol-related problems (Fleming & Ledogar, 2008; Garroutte et al, 2009; Iwasaki & Byrd, 2010; Torres Stone, Whitbeck, Chen, Johnson, & Olson, 2006). Traditionally, AI/AN enculturation has been inseparable from spiritual beliefs and practices, reflecting cosmologies in which the spiritual is intertwined with all aspects of daily life (Greenfield et al, 2015; Kulis, Hodge, Ayers, Brown, & Marsiglia, 2012). Specific beliefs and practices vary considerably between and within tribes and include traditional Native spiritual traditions, Christianity, and syncretic combinations of Indigenous and Christian traditions (e.g., the Native American Church; Garroutte et al, 2009; Kulis et al, 2012).…”

Substance Use Research with Indigenous Communities: Exploring and Extending Foundational Principles of Community Psychology

“…Primary outcomes included percent of days abstinent from alcohol, marijuana, and all drugs via self‐report and an oral swab drug screen; spirituality was also measured over time. Pilot outcomes ( N = 8) at 8‐month follow‐up yielded medium effect sizes for improvements in percent of days abstinent for alcohol, marijuana, and all drugs, as well as reductions in psychological distress (Venner et al., ) and increased spiritual behaviors and beliefs (Greenfield et al., ). Analyses of RCT data comparing MICRA to treatment‐as‐usual are underway.…”