Program focused on culture, family may improve alcohol use in American Indians

Key takeaways:

• A culture-based alcohol use disorder program for American Indians elicited positive outcomes.
• It is important to align your treatment with the patients’ culture and gender.

SAN FRANCISCO — A culture-based program improved alcohol use disorder in American Indians, according to a presenter at the American Psychiatric Association annual meeting.

“The one thing that was attacked in colonization was culture and values, and the things actually helping substance abuse prevention are culture-based,” Catherine McKinley, PhD, an associate professor in the Tulane University School of Social Work in New Orleans, said during the presentation. “The Native people that I work with are female-centered [and focused on] matrilocal, complementary gender roles; more connection to the land; subsistence and food waste; traditions; and spirituality.”

McKinley and colleagues developed the Weaving Healthy Families program, which enrolled Choctaw families to participate in 10 weekly sessions. Each session involved a family dinner, after which participants attended discussion circle events with their peers, with parents, youth, school-aged children and younger children attending separate discussion circles. All discussion circles focused on the same topics but were tailored to the developmental stages of participants.

Following the discussion circles, families came back together to participate in an activity related to mental or physical health.

Pilot results from the program were promising, according to McKinley. There were significant improvements in the ecological levels of the Framework of Historical Oppression, Resilience and Transcendence.

In the first set of pilot results from baseline to 9 months after enrollment, these improvements encompassed areas such as communal mastery and social support; resilience and family environment; intimate partner violence; emotional regulation, health-related quality of life and sugar beverage consumption. In the second set of pilot results from baseline through 12 months after enrollment, there were improvements in substance, drug and alcohol use; anxiety; parenting; communal mastery; and discrimination.

“We did find that these outcomes were different by gender, and we found that a lot of the burden on a lot of mothers was related to inequities related to household and home life,” McKinley said. “We found that male parents improved their outcomes to the level of the mothers were [at baseline] by the end.”

Moving forward, McKinley said the program will expand to include more nature-based topics because they found it to be helpful in promoting wellness and preventing substance abuse.