Preventing alcohol-exposed pregnancy among American-Indian youth

Abstract

Research has determined that the prevention of alcohol-exposed pregnancies (AEP) must occur pre-conceptually with women, either by reducing alcohol intake in women planning pregnancy or at-risk for becoming pregnant, or by preventing pregnancy in women drinking at risky levels. One such AEP prevention programme with non-pregnant American Indian women is the Oglala Sioux Tribe (OST) CHOICES (Changing High-risk alcohOl use and Increasing Contraception Effectiveness Study) Programme, which shows promise in reducing AEP risk in American Indian women aged 18 or older. A community needs assessment was conducted with key informant interviews and focus groups with an emphasis on how to expand OST CHOICES. To identify interconnected themes, a content analysis methodology was used on the qualitative feedback from the focus groups and interviews. Altogether, key informant interviews were completed with 25 health and social service professionals. Eight focus groups were held with 58 American Indian participants, including adult women of child-bearing age, elder women, and adult men. Several sub-themes regarding the prevention of AEP with youth were identified, expanding the OST CHOICES curriculum into the schools, and the role of family and culture within AEP prevention.

Community Perceptions of Alcohol Exposed Pregnancy Prevention Program for American Indian and Alaska Native Teens

“…There is both an epidemiological need and also a community-defined need for AEP prevention in AIAN youths. Findings from past studies cite the need for AEP prevention in youths, and the tribal community responding in this project agreed with the need for AEP prevention with AIAN youths [36]. A similar qualitative study with urban AIAN adolescents and adults also found that FASD prevention should consider cultural and community values and contexts [46].…”

“…The team has collaborated with this particular tribal community since approximately 2004 and has developed several community-led research interventions [44,48,49]. For this study, we used several tenants of community-based participatory research (CBPR) in that the community defined AEP prevention for youths as a need within the community [36], and we gathered vast community input through our formative qualitative work, constructing an intervention based on community-driven data. We also wanted to meet the needs of the youth population by utilizing technology to deliver the intervention.…”

“…A community needs assessment that ran parallel to the CHOICES work with AIAN adult women highlighted the need to reduce the risk for AEP in AIAN adolescent girls [36]. The study noted different themes that were highlighted by the community in order to expand the CHOICES program on Native communities.…”

“…To meet this need, the CHOICES for American Indian Teens (CHAT) Program was developed to adapt the evidence-based CHOICES intervention for use with AIAN teen girls. The CHAT team aimed to gather additional community input to revise and adapt the CHOICES curriculum and to pilot test this curriculum with female AIAN adolescents aged 14–18 [36].…”

The Oglala Sioux Tribe CHOICES Program: Modifying an Existing Alcohol-Exposed Pregnancy Intervention for Use in an American Indian Community

“…To meet this community need, we are in the process of piloting the CHOICES intervention in a group setting, a methodology that utilizes cultural norms of group communication and provides support through group interaction [ 27 ]. Through our community engagement, we also identified a need to work with adolescents and young American Indian women to expand the population we work with, and we have applied for funding to expand to that group [ 28 ]. With this important community input and with extensive opportunities for expansion, the OST CHOICES Program will only grow in the coming years and expand to serve additional women in the movement to prevent AEP.…”