This study explored the drug resistance strategies that urban American Indian adolescents consider the best and worst ways to respond to offers of alcohol, cigarettes, and marijuana. Focus group data were collected from 11 female and 9 male American Indian adolescents attending urban middle schools in the southwest. The youth were presented with hypothetical substance offer scenarios and alternative ways of responding, based on real-life narratives of similar youth. They were asked to choose a preferred strategy, one that would work every time, and a rejected strategy, one they would never use. Using eco-developmental theory, patterns in the preferred and rejected strategies were analyzed to identify culturally specific and socially competent ways of resisting substance offers. The youth preferred strategies that included passive, non-verbal strategies like pretending to use the substance, as well as assertive strategies like destroying the substance. The strategies they rejected were mostly socially non-competent ones like accepting the substance or responding angrily. Patterns of preferred and rejected strategies varied depending on whether the offer came from a family member or non-relative. These patterns have suggestive implications for designing more effective prevention programs for the growing yet underserved urban American Indian youth population.
Get full access to this article
View all access options for this article.
References
1.
AckermanL. (1988). Residential mobility among the Colville Indians. Washington, DC: Center for Survey Methods Research, Bureau of the Census.
2.
AckermanL. (1989). Residents or visitors: Finding motives for movements in an Indian population. Paper presentation at the Society for Applied Anthropology, Santa Fe, New Mexico.
3.
AlbertsJ. K.Miller-RassuloM. A.HechtM. L. (1991). A typology of drug resistance strategies. Journal of Applied Communication Research, 19, 129–151.
4.
AlvordL.Van PeltE. (1999). The scalpel and the silver bear: The first Navajo woman surgeon combines Western medicine and traditional healing. New York: Bantam Books.
5.
ArguellesL.BuchwaldD.GarroutteE. M.GoldbergJ.SarkisianN. (2006). Cultural identities and perceptions of health among health care providers and older American Indians. Journal of General Internal Medicine, 21, 111–116.
6.
Arizona Public Health Association. (2005). Health disparities in Arizona's racial and ethnic minority populations: Living and dying in Arizona. Report prepared through the Office of Minority Health, U.S. Department of Health and Human Services. Center for Substance Abuse Prevention, Rockville, MD.
BaldwinJ. A.MaxwellC. J.FenaughtyA. M.TrotterR. T.StevensS. J. (2000). Alcohol as a risk factor for HIV transmission among American Indian and Alaska Native drug users. American Indian and Alaska Native Mental Health Research, 9, 1–16.
9.
BatesS. C.BeauvaisF.TrimbleJ. E. (1997). American Indian adolescent alcohol involvement and ethnic identification. Substance Use and Misuse, 32(14), 2013–2031.
10.
BeauvaisF. (1992). Drug use of friends: A comparison of reservation and non-reservation Indian youth. American Indian and Alaska Native Mental Health Research, 5(1), 43–50.
11.
BeauvaisF. (1998). American Indians and alcohol. Alcohol Health and Research World, 22, 253–259.
12.
BeauvaisF.TrimbleJ. E. (2003). The effectiveness of alcohol and drug abuse prevention among American-Indian youth. In SlobodaZ.BukoskiW. J. (Eds.), Handbook of drug abuse prevention: Theory, science, and practice (pp. 393–410). New York: Kluwer.
13.
BonvillainN. (1989a). Residence patterns at the St. Regis Reservation. Ethnographic Exploratory Research Report #5, Center for Survey Methods Research, Bureau of the Census. Washington, DC.
14.
BonvillainN. (1989b). The census process at St. Regis Reservation. Center for Survey Methods Research, Bureau of the Census, Washington, DC.
15.
BotvinG. J.SchinkeS. P.EpsteinJ. A.DiazT. (1994). Effectiveness of culturally focused and generic skills training approaches to alcohol and drug abuse prevention among minority youths. Psychology of Addictive Behaviors, 8(2), 116–127.
16.
BrowneA. J.FiskeJ. (2001). First Nations women's encounters with mainstream health care services. Western Journal of Nursing Research, 23(2), 126–147.
17.
CastorM. L.ForqueraR. A.LawsonS. A.ParkA. N.SmyserM. S.TaualiiM. M. (2006). A nationwide population-based study identifying health disparities between American Indians/Alaska Natives and the general populations living in select urban counties. American Journal of Public Health, 96(8), 1478–1484.
18.
Centers for Disease Control. (2001). Death rates and number of deaths by state, race, sex, age and cause, 1994–1998. Atlanta, GA.
ChavezV.DuranB.BakerQ. E.AvilaM. M.WallersteinN. (2003). The dance of race and privilege in community based participatory research. In MinklerM.WallersteinN. (Eds.), Community based participatory research for health (pp. 81–97). San Francisco, CA: Jossey Bass.
21.
ChewningB.DouglasJ.KokotailoP. K.LaCourtJ.ClairD.WilsonD. (2001). Protective factors associated with American Indian adolescents' safer sexual patterns. Maternal and Child Health, 5(4), 273–280.
22.
ClarkeA. S. (2002). Social and emotional distress among American Indian and Alaska Native students: Research findings. [Electronic Version]. Charleston, WV: ERIC Digest. Retrieved March 4, 2005, from http://www.ael.org/page.htm?andid=503andpd=res8721
23.
CoatsworthJ. D.PantinH.McBrideC.BrionesE.KurtinesW.SzapocznikJ. (2002). Ecodevelopmental correlates of behavior problems in young Hispanic females. Applied Developmental Science, 6(3), 126–143.
24.
DixonM. (2001). Access to care issues for Native American consumers. In DixonM.RoubideauxY. (Eds.), Promises to keep: Public health policy for American Indians and Alaska Natives in the 21st century (pp. 61–88). Washington, DC: American Public Health Association.
25.
DixonA. L.YabikuS. T.OkamotoS. K.TannS. S.MarsigliaF. F.KulisS. (2007). The efficacy of a multicultural prevention intervention among urban American Indian youth in the Southwest U.S. Journal of Primary Prevention, 28, 547–568.
26.
DoiS. C.DiLorenzoT. M. (1993). An evaluation of a tobacco use education-prevention program: A pilot study. Journal of Substance Abuse, 5, 73–78.
27.
DorpatN. (1994). PRIDE: Substance abuse education/intervention program. American Indian and Alaska Native Mental Health Research: Journal of the National Center, 4, 122–133.
28.
DuranB. G.WallersteinN.MillerW. R. (2007). New approaches to alcohol interventions among American Indian and Latino communities: The experience of the Southwest Addictions Research Group. Alcoholism Treatment Quarterly, 25, 1–10.
29.
DuranB.WaltersK. L. (2004). HIV/AIDS prevention in “Indian country”: Current practice, indigenist etiology models, and postcolonial approaches to change. AIDS Education and Prevention, 16, 187–201.
30.
FenaughtyA. M.FisherD. G.CagleH. H.StevensS.BaldwinJ. A.BoothR. (1998). Sex partners of Native American drug users. Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology, 17, 275–282.
31.
FrankJ. W.MooreR. S.AmesG. M. (2000). Historical and cultural roots of drinking problems among American Indians. American Journal of Public Health, 90, 344–351.
32.
GarrettM. T.CarrollJ. J. (2000). Mending the broken circle: Treatment of substance dependence among Native Americans. Journal of Counseling and Development, 78(4), 379–388.
33.
GarrettM. T.HerringR. D. (2001). Honoring the power of relation: Counseling Native adults. Journal for Humanistic Counseling, Education, and Development, 40, 139–151.
34.
GilchristL.SchinkeS. P.TrimbleJ. E.CvetkovichG. (1987). Skills enhancement to prevent substance abuse among American Indian adolescents. International Journal on the Addictions, 22, 869–879.
35.
GosinM.MarsigliaF. F.HechtM. L. (2003). Keepin it R.E.A.L.: A drug resistance curriculum tailored to the strengths and needs of pre-adolescents of the southwest. Journal of Drug Education, 33(2), 119–142.
36.
GuilleminJ. (1975). Urban renegades: The cultural strategy of American Indians. New York: Columbia University Press.
37.
HawkinsE. H.CumminsL. H.MarlattG. A. (2004). Preventing substance abuse in AI and Alaska Native youth: Promising strategies for healthier communities. Psychological Bulletin, 130(2), 304–323.
38.
HechtM. L.AlbertsJ. K.Miller-RassuloM. (1992). Resistance to drug offers among college students. The International Journal of the Addictions, 27(8), 995–1017.
39.
HechtM. L.MarsigliaF. F.Elek-FiskE.WagstaffD. A.KulisS.DustmanP. (2003). Culturally-grounded substance use prevention: An evaluation of the keepin' it REAL curriculum. Prevention Science, 4(4), 233–248.
40.
HechtM. L.RibeauS.AlbertsJ. K. (1989). An Afro-American perspective on interethnic communication. Communication Monographs, 56, 385–410.
41.
HellerstedtW. L.Peterson-HickeyM.RhodesK. L.GarwickA. (2006). Environmental, social, and personal correlates of having ever had sexual intercourse among American Indian youths. American Journal of Public Health, 96, 2228–2234.
42.
HerringR. D. (1997a). Counseling diverse ethnic youth: Synergetic strategies and interventions for school counselors. Fort Worth, TX: Harcourt Brace.
43.
HerringR. D. (1997b). Counseling indigenous American youth. In LeeC. C. (Ed.), Multicultural issues in counseling: New approaches to diversity (2nd ed., pp. 53–70). Alexandria, VA: American Counseling Association.
44.
HurdleD.OkamotoS.MilesB. (2003). Family influences on alcohol and drug use by AI youth: Implications for prevention. Journal of Family Social Work, 7(1), 53–68.
45.
Indian Health Service. (2001). Health disparities trends. Rockville, MD: Indian Health Service. Retrieved August 13, 2003, from http://info.ihs.gov/Health/Health1.pdf
46.
Indian Health Service. (2004). Trends in Indian health, 2000–2001. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service.
47.
Indian Health Service. (2005). Facts on Indian health disparities. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service.
48.
Indian Health Service. (2009). Trends in Indian health, 2002–2003. Rockville, MD: U.S. Department of Health and Human Services, Public Health Service.
49.
JacksonC.HenriksenL.DickinsonD.LevineD. W. (1997). The early use of alcohol and tobacco: Its relation to children's competence and parent's behavior. American Journal of Public Health, 87(3), 359–364.
50.
Joseph-FoxY.KekahbahT. M. (1999). Establishing a national health services research agenda for American Indians and Alaska Natives. Denver, CO: National Indian Health Board.
51.
KeglerM. C.KingsleyB.MalcoeL. H.CleaverV.ReidJ.SolomonG. (1999). The functional value of smoking and nonsmoking from the perspective of American Indian youth. Family and Community Health, 22(2), 31–42.
52.
KingM.SmithA.GraceyM. (2009). Indigenous health, Part 2: The underlying causes of the health gap. Lancet, 374, 76–85.
53.
KulisS.MarsigliaF. F.CastilloJ.BecerraD.NieriT. (2008). Drug resistance strategies and substance use among adolescents in Monterrey, Mexico. Journal of Primary Prevention, 29(2), 167–192.
54.
KulisS.MarsigliaF. F.ElekE.DustmanP.WagstaffD. A.HechtM. L. (2005). Mexican/Mexican American adolescents and keepin' it REAL: An evidence-based substance use prevention program. Children and Schools, 27(3), 134–145.
55.
KulisS.OkamotoS. K.RayleA. D.NyakoeS. (2006). Social contexts of drug offers among American Indian youth and their relationship to drug use: An exploratory study. Cultural Diversity and Ethnic Minority Psychology, 12(1), 20–44.
56.
KulisS.ReevesL. J.DustmanP. A.O'NeillM. (in press). Drug resistance strategies of urban American Indian youth of the southwest: An enumeration, classification, and analysis by substance and offeror. Substance Use and Misuse.
57.
LaFromboiseT. D.TrimbleJ. E.MohattG. V. (1990). Counseling intervention and American Indian tradition: An integrative approach. Counseling Psychologist, 18, 628–654.
58.
LoboS. (2001). Is urban a person or a place? Characteristics of urban Indian country. In LoboS.PetersK. (Eds.), The urban experience of American Indians (pp. 73–84). Walnut Creek, CA: Alta Mira Press.
59.
MacNeilG.LeCroyC. W. (1997). Promoting social competence among severely emotionally disturbed youth: Development of a social competence inventory. Residential Treatment for Children and Youth, 15, 63–78.
60.
MailP. D. (1995). Early modeling of drinking behavior by Native American elementary school children playing drunk. International Journal of the Addictions, 30, 1187–1197.
61.
MarlattG. A.LarimerM. E.MailP. D.HawkinsE. H.CumminsL. H.BlumeA. W. (2003). Journeys of the Circle: A culturally congruent life skills intervention for adolescent Indian drinking. Alcoholism: Clinical and Experimental Research, 27(8), 1–3.
62.
MarsigliaF. F.HechtM. L. (2005). Keepin' it REAL: An evidence-based program. Santa Cruz, CA: ETR Associates.
63.
MayP. A.MoranJ. R. (1995). Prevention of alcohol misuse: A review of health promotion efforts among American Indians. American Journal of Health Promotion, 9, 288–299.
64.
MoncherM. S.HoldenG. W.TrimbleJ. E. (1990). Substance abuse among Native American youth. Journal of Consulting and Clinical Psychology, 58, 408–415.
65.
MoonD. G.HechtM. L.JacksonK. M.SpellersR. E. (1999). Ethnic and gender differences and similarities in adolescent drug use and refusals of drug offers. Substance Use and Misuse, 34(8), 1059–1083.
66.
MoranJ. (1998). Alcohol prevention among urban American Indian youth. Journal of Human Behavior in the Social Environment, 2(1/2), 51–68.
67.
MoranJ. R.BusseyM. (2007). Results of an alcohol prevention program with urban American Indian youth. Journal Child and Adolescent Social Work Journal, 24, 1–21.
68.
MoranJ. R.FlemingC. M.SomervellP.MansonS. M. (1999). Measuring bicultural ethnic identity among American Indian adolescents: A factor analytic study. Journal of Adolescent Research, 14, 405–426.
69.
MoranJ. R.ReamanJ. A. (2002). Critical issues for substance abuse prevention targeting American Indian youth. The Journal of Primary Prevention, 22, 201–233.
70.
MoreA. J. (1989). Native Indian learning styles: A review for researchers and teachers. Journal of American Indian Education, Special Edition, 28(4), 15–28.
71.
MrelaC. K.TorresC. (2008). Differences in the health status among race/ethnic groups, Arizona, 2007. Phoenix, AZ: Arizona Department of Health Services. Retrieved from http://azdhs.org/plan/report/dhsag/dhsag07/ethnic07.pdf
72.
National Urban Indian Family Coalition. (2008). Urban Indian America. Report to the Annie E. Casey Foundation. Seattle, WA: National Urban Indian Family Coalition.
73.
NebelkopfE.PhillipsM. (Eds.). (2004). Healing and mental health for Native Americans: Speaking in red. Walnut Creek, CA: Alta Mira Press.
74.
NeuendorfK. A. (2002). The content analysis guidebook. Thousand Oaks, CA: Sage.
75.
NielsenS. K. (1994). An ecological assessment of the school-based substance abuse psychological services for Native American youth. Unpublished doctoral dissertation, Northern Arizona University.
76.
NovinsD. K.MitchellC. M. (1998). Factors associated with marijuana use among American Indian adolescents. Addiction, 93, 1693–1702.
77.
OkamotoS. K.LeCroyC. W.DustmanP.Hohmann-MarriottB.KulisS. (2004). An ecological assessment of drug related problem situations for American Indian adolescents of the Southwest. Journal of Social Work Practice in the Addictions, 4, 47–63.
78.
OkamotoS. K.LeCroyC. W.TannS. S.RayleA. D.KulisS.DustmanP. (2006). The implications of ecologically based assessment for prevention science with indigenous youth populations. The Journal of Primary Prevention, 27, 155–177.
79.
PerrinoT.Gonzalez-SoldevillaA.PantinH.SzapocznikJ. (2000). The role of families in HIV prevention: A review. Clinical Child and Family Psychology Review, 3, 81–96.
80.
RayleA. D.KulisS.OkamotoS. K.TannS. S.LeCroyC. W.DustmanP. (2006). Who is offering and how often? Gender differences in drug offers among American Indian adolescents of the Southwest. Journal of Early Adolescence, 26(3), 1–22.
81.
ReardonK. (1989). The potential role of persuasion in adolescent AIDS prevention. In SalmonC. T. (Ed.), Information campaigns: Balancing social values and social change (pp. 273–289). Beverly Hills, CA: Sage.
82.
RutmanS.ParkA.CastorM.TaualiiM.ForqueraR. (2008). Urban American Indiana and Alaska Native Routh: Youth risk behavior Survey 1997–2003. Maternal and Child Health Journal, 12, 76–81.
83.
SaloM. T. (1995). Findings from focus groups with urban Indians of Los Angeles County, California. Statistics Research Division, U.S. Bureau of the Census, Washington, DC.
84.
SchinkeS. P. (1999). Preventing alcohol abuse among Native American youth. Unpublished document. Progress report to the National Institute on Alcohol Abuse and Alcoholism.
85.
SchinkeS. P.OrlandiM. A.BotvinG. J.GilchristL. D.TrimbleJ. E.LocklearV. S. (1988). Preventing substance abuse among American Indian adolescents: A bicultural competence skills approach. Journal of Counseling Psychology, 35, 87–90.
SchinkeS. P.TepavacL.ColeK. C. (2000). Preventing substance use among Native American youth: Three year results. Addictive Behaviors, 25, 387–398.
88.
SellersC. S.WinfreeL. T.GriffithsC. T. (1993). Legal attitudes, permissive norm qualities, and substance use: A comparison of American Indian and non-Indian youth. Journal of Drug Issues, 23, 493–513.
89.
SimoniJ. M.SehgalS.WaltersK. L. (2004). Triangle of risk: Urban American Indian women's sexual trauma, injection drug use, and HIV sexual risk behaviors. Journal of AIDS and Behavior, 8, 33–45.
90.
SkaraS.SussmanS. (2003). A review of 25 long-term adolescent tobacco and other drug use prevention program evaluations. Preventive Medicine, 37, 451–474.
91.
StiffmanA. R.StrileyC.BrownE.LimbG.OstmannE. (2003). American Indian youth: Who southwestern urban and reservation youth turn to for help with mental health or addictions. Journal of Child and Family Studies, 12, 319–333.
92.
StrausT. (1998). Retribalization in urban Indian communities. The American Indian Culture and Research Journal, 22, 103–116.
93.
StubbenJ. D. (2001). Working with and conducting research among American Indian families. American Behavioral Scientist, 44, 1466–1481.
94.
Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. (2004). Results from the 2003 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 04-3964, NSDUH Series H-25). Rockville, MD: Substance Abuse and Mental Health Services Administration.
95.
Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 05-4062, NSDUH Series H-28). Rockville, MD: Substance Abuse and Mental Health Services Administration.
96.
Substance Abuse and Mental Health Services Administration (SAMHSA), Office of Applied Studies. (2006). Results from the 2005 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 06-4194, NSDUH Series H-30). Rockville, MD: Substance Abuse and Mental Health Services Administration.
97.
SzapocznikJ.CoatsworthJ. D. (1999). An ecodevelopmental framework for organizing the influences on drug abuse: A developmental model of risk and protection. In GlantzM.HartelC. R. (Eds.), Drug abuse: Origins and interventions (pp. 331–366). Washington, DC: American Psychological Association.
98.
TrimbleJ. E. (1992). A cognitive-behavioral approach to drug abuse prevention and intervention with American Indian youth. In VargasL. A.Koss-ChioinoJ. D. (Eds.), Working with culture: Psychotherapeutic interventions with ethnic minority children and adolescents (pp. 246–275). San Francisco, CA: Jossey-Bass.
99.
TrotterR. T.RolfJ. E.BaldwinJ. A. (1997). Cultural models of inhalant abuse among Navajo youth. Drugs and Society, 10(1–2), 39–59.
100.
Urban Indian Coalition of Arizona. (2009). Community needs assessment on underage drinking. Report to the Magellan Health System of Arizona. Phoenix, AZ: Urban Indian Coalition of Arizona.
101.
Urban Indian Health Commission. (2007). Invisible tribes: Urban Indians and their health in a changing world. Seattle, WA: Urban Indian Health Commission.
102.
WallerM. A.OkamotoS. K.MilesB. W.HurdleD. E. (2003). Resiliency factors related to substance use/resistance: Perceptions of Native adolescents of the Southwest. Journal of Sociology and Social Welfare, 30(4), 79–94.
103.
WaltersK. L.SimoniJ. M.Evans-CampbellT. (2002). Substance use among American Indians and Alaska Natives: Incorporating culture in an “Indigenist” stress-coping paradigm. U.S. Department of Health and Human Services, Public Health Reports, 117(Suppl 1): S104–S117.
104.
Weibel-OrlandoJ. (1991). Indian Country, L.A.: Maintaining ethnic community in complex society. Urbana, IL: University of Illinois Press.
105.
WhitbeckL. B.HoytD. R.McMorrisB. J.ChenX.StubbenJ. D. (2001). Perceived discrimination and early substance abuse among American Indian children. Journal of Health and Social Behavior, 42, 405–424.
106.
WhitbeckL. B.ChenX.HoytD. R.AdamsG. W. (2004). Discrimination, historical loss and enculturation: Culturally specific risk and resiliency factors for alcohol abuse among American Indians. Journal of Studies on Alcohol, 65, 409–418.
