Tri-Ethnic Center

College of Natural Sciences

Substance Use Among American Indian Youth

Purpose and Design

Purpose

The Tri-Ethnic Center for Prevention Research (TEC) has been funded by the National Institute on Drug Abuse (NIDA) to track the substance use of American Indian (AI) youth who live on or near AI reservations since 1974. Over more than 30 years of surveillance, our data, along with that of others show consistently that among all U.S. ethnic minority groups, AI adolescents report the highest levels of substance use. Moreover, reservation-based AI youth have been found to have higher substance use and other related problems than non-reservation AI youth. Through systematic tracking of annual substance use of AI youth, we have been able to identify key trends that have marked significant reductions in levels of use as well as marked increases in use. Ongoing surveillance allows continued monitoring of significant trends that are critical for targeting both prevention and intervention efforts, both being vitally important given that substance use related problems, such as academic failure, delinquency, violent criminal behavior, suicidality, and especially for AI males, drinking-related arrests and alcohol-related mortality are disproportionately high on most reservations.

In addition to our annual tracking of substance use epidemiology, we have also investigated the etiology of AI adolescent substance use and associated correlates of use, along with theory development and other topics relevant to the investigation of substance use among this group. Our investigations of the etiology and associated correlates of use have shown that there are both commonalities and differences in substance use etiology and risk between AI and non-AI youth, leading to theory development and other topics relevant to the investigation of substance use among this and other ethnic minority groups.

 

Design

Sample. The sampling frame consists of middle/junior high and high schools, including public schools and Bureau of Indian Education (BIE) and tribally operated schools overseen by the BIE, that draw 7th – 12th grade American Indian (AI) youth who live on or near reservations. The sampling scheme is based on six geographic regions in which reservation-based AIs reside (Northwest, Northern Plains, Northeast, Southeast, Southern Great Plains, and Southwest), with recruitment in each region to approximate the percentage of AIs residing in each respective region based on the most recent Census data for designated AI areas. Schools are randomly selected within each region and asked to participate. If a school declines, a similar school in terms of region and size is randomly selected and asked to participate. In order to survey a sufficient number of AI youth, we target approximately 15 schools each year.

Survey procedures. Surveys are administered during a normal classroom session by school staff that have completed IRB-approved training or by trained TEC staff. All students attending school on that day take the survey. Parents can opt their child out, and students can also decline to participate by informing the teacher and may also leave blank any questions they do not wish to answer. Instructions are read to students before they complete the survey, and teachers and/or staff are instructed to remain in the area but not close enough to observe any students’ specific responses. Once the survey is completed, students randomly place the survey in a large envelope, which is sealed and returned to TEC for scanning. Surveys are then scanned and run through computerized checks that identify inconsistent responders and exaggerators. Individuals who fall into these categories typically account for 2-4% and are eliminated from the data prior to analysis.

Adolescent survey instrument. The drug and alcohol use questions are predominantly from the American Drug and Alcohol Survey (ADAS) – a survey that has been developed to be used with both minority and majority youth. Versions of the survey have been administered to over 1,000,000 White American youth, 75,000 AI youth, 70,000 Mexican-American youth and over 75,000 African American youth. Several different drug use measures are derived from the survey including prevalence (e.g., lifetime, annual, last month, 2-week binge drinking) and scales assessing level of drug involvement. The survey also asks a variety of questions related to peer substance use, descriptive and injunctive norms, school adjustment, relationships with family and peers, and other individual and community risk factors for substance use.