IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i7p4283-d786367.html
   My bibliography  Save this article

Empowering Our People: Syndemic Moderators and Effects of a Culturally Adapted, Evidence-Based Intervention for Sexual Risk Reduction among Native Americans with Binge Substance Use

Author

Listed:
  • Christopher G. Kemp

    (Center for American Indian Health, Johns Hopkins University, Baltimore, MD 21231, USA)

  • Rachel Chambers

    (Center for American Indian Health, Johns Hopkins University, Baltimore, MD 21231, USA)

  • Francene Larzelere

    (Center for American Indian Health, Johns Hopkins University, Baltimore, MD 21231, USA)

  • Angelita Lee

    (Center for American Indian Health, Johns Hopkins University, Baltimore, MD 21231, USA)

  • Laura C. Pinal

    (Center for American Indian Health, Johns Hopkins University, Baltimore, MD 21231, USA)

  • Anna M. Slimp

    (Center for American Indian Health, Johns Hopkins University, Baltimore, MD 21231, USA)

  • Lauren Tingey

    (Center for American Indian Health, Johns Hopkins University, Baltimore, MD 21231, USA)

Abstract

Native American (NA) communities are disproportionately affected by the intersecting, synergistic epidemics of sexually transmitted infections (STIs) and substance use. Targeted approaches to addressing these syndemics are critical given the relative scarcity of mental health and behavioral specialists in NA communities. We conducted a series of moderation analyses using data from a randomized controlled trial of the EMPWR (Educate, Motivate, Protect, Wellness, Respect) intervention for reducing sexual risk behaviors, culturally adapted for NA adults with recent binge substance use living on rural reservations. We considered several potential moderators and substance use and sexual risk outcomes at 6- and 12-months post-baseline. Three hundred and one people participated in the study. Age, marital status, educational attainment, employment, and depressive symptoms were differentially associated with intervention effects. EMPWR could be strengthened with the incorporation of additional skills-building related to condom use negotiation with casual partners. For individuals with lower educational attainment or without employment, additional supports and approaches to intervention may be needed. Importantly, this study did not identify intersecting sexual risk and substance use behaviors as moderators of EMPWR effectiveness, suggesting that NA adults with varying levels of risk behavior may be equally likely to benefit from this intervention.

Suggested Citation

  • Christopher G. Kemp & Rachel Chambers & Francene Larzelere & Angelita Lee & Laura C. Pinal & Anna M. Slimp & Lauren Tingey, 2022. "Empowering Our People: Syndemic Moderators and Effects of a Culturally Adapted, Evidence-Based Intervention for Sexual Risk Reduction among Native Americans with Binge Substance Use," IJERPH, MDPI, vol. 19(7), pages 1-11, April.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:7:p:4283-:d:786367
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/7/4283/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/7/4283/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Kalichman, S.C. & Cain, D. & Eaton, L. & Jooste, S. & Simbayi, L.C., 2011. "Randomized clinical trial of brief risk reduction counseling for sexually transmitted infection clinic patients in Cape Town, South Africa," American Journal of Public Health, American Public Health Association, vol. 101(9), pages 9-17.
    2. Warne, D. & Frizzell, L.B., 2014. "American Indian Health Policy: Historical trends and contemporary issues," American Journal of Public Health, American Public Health Association, vol. 104(S3), pages 263-267.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Held, Suzanne & Hallett, John & Schure, Mark & Knows His Gun McCormick, Alma & Allen, Sarah & Milne-Price, Shauna & Trottier, Coleen & Bull Shows, Brianna & Other Medicine, Lucille & Inouye, Jillian, 2019. "Improving chronic illness self-management with the Apsáalooke Nation: Development of the Báa nnilah program," Social Science & Medicine, Elsevier, vol. 242(C).
    2. Kiana Wilkins, 2022. "Intersectional Immunity? Examining How Race/Ethnicity and Sexual Orientation Combine to Shape Influenza Vaccination Among US Adults," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 41(6), pages 2585-2612, December.
    3. Katherine Leggat-Barr & Fumiya Uchikoshi & Noreen Goldman, 2021. "COVID-19 risk factors and mortality among Native Americans," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 45(39), pages 1185-1218.
    4. Timian M. Godfrey & Edgar A. Villavicencio & Kimberly Barra & Priscilla R. Sanderson & Kimberly Shea & Xiaoxiao Sun & David O. Garcia, 2022. "Advancing Liver Cancer Prevention for American Indian Populations in Arizona: An Integrative Review," IJERPH, MDPI, vol. 19(6), pages 1-16, March.
    5. Eileen V Pitpitan & Shirley J Semple & Gregory A Aarons & Lawrence A Palinkas & Claudia V Chavarin & Doroteo V Mendoza & Carlos Magis-Rodriguez & Hugo Staines & Thomas L Patterson, 2018. "Factors associated with program effectiveness in the implementation of a sexual risk reduction intervention for female sex workers across Mexico: Results from a randomized trial," PLOS ONE, Public Library of Science, vol. 13(9), pages 1-17, September.
    6. Julie A. Beans & Bobby Saunkeah & R. Brian Woodbury & Terry S. Ketchum & Paul G. Spicer & Vanessa Y. Hiratsuka, 2019. "Community Protections in American Indian and Alaska Native Participatory Research—A Scoping Review," Social Sciences, MDPI, vol. 8(4), pages 1-18, April.
    7. Jaramillo, Elise Trott & Willging, Cathleen E., 2021. "Producing insecurity: Healthcare access, health insurance, and wellbeing among American Indian elders," Social Science & Medicine, Elsevier, vol. 268(C).
    8. Adrian Flint, 2015. "Traditional Healing, Biomedicine and the Treatment of HIV/AIDS: Contrasting South African and Native American Experiences," IJERPH, MDPI, vol. 12(4), pages 1-19, April.
    9. Thorsen, Maggie L. & Harris, Sean & Palacios, Janelle F. & McGarvey, Ronald G. & Thorsen, Andreas, 2023. "American Indians travel great distances for obstetrical care: Examining rural and racial disparities," Social Science & Medicine, Elsevier, vol. 325(C).
    10. Julie A. Beans & Bobby Saunkeah & R. Brian Woodbury & Terry S. Ketchum & Paul G. Spicer & Vanessa Y. Hiratsuka, 2019. "Correction: Beans, J.A.; et al. Community Protections in American Indian and Alaska Native Participatory Research–A Scoping Review. Soc. Sci . 2019, 8(4), 127," Social Sciences, MDPI, vol. 8(9), pages 1-2, August.
    11. Melissa E. Lewis & Hannah I. Volpert-Esmond & Jason F. Deen & Elizabeth Modde & Donald Warne, 2021. "Stress and Cardiometabolic Disease Risk for Indigenous Populations throughout the Lifespan," IJERPH, MDPI, vol. 18(4), pages 1-24, February.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:7:p:4283-:d:786367. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.