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Alcohol and Substance Use Among American Indian/Alaska Native Birthing People : = A Mixed Methods Study of Punitive versus Treatment State Policies and Community Level Risk Factors.

Record Type:	Language materials, manuscript : Monograph/item
Title/Author:	Alcohol and Substance Use Among American Indian/Alaska Native Birthing People :/
Reminder of title:	A Mixed Methods Study of Punitive versus Treatment State Policies and Community Level Risk Factors.
Author:	Coleman, Addie Katherine.
Description:	1 online resource (165 pages)
Notes:	Source: Dissertations Abstracts International, Volume: 85-11, Section: B.
Contained By:	Dissertations Abstracts International85-11B.
Subject:	Public health. -
Online resource:	click for full text (PQDT)
ISBN:	9798382630038

Alcohol and Substance Use Among American Indian/Alaska Native Birthing People : = A Mixed Methods Study of Punitive versus Treatment State Policies and Community Level Risk Factors.
Coleman, Addie Katherine.

Alcohol and Substance Use Among American Indian/Alaska Native Birthing People :A Mixed Methods Study of Punitive versus Treatment State Policies and Community Level Risk Factors. - 1 online resource (165 pages)

Source: Dissertations Abstracts International, Volume: 85-11, Section: B.

Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2024.

Includes bibliographical references

The main research objective of this dissertation was to better understand the policy, predisposing and enabling factors related to prenatal alcohol and substance use among the American Indian/Alaska Native (AI/AN) birthing population in the United States. Aim 1 assessed the impact of state prenatal substance use policies (PSUP) on prenatal care timing and adequacy for American Indian/Alaska Native (AI/AN) birthing people compared to NH-white birthing people. Aim 2 assessed barriers to prenatal care among AI/AN birthing people compared to their NH-white counterparts and examined the association of interpersonal violence (IPV) and alcohol and substance use (A/SU) with barriers to prenatal care. Aim 3 utilized a convergent mixed-methods approach to quantitatively assess factors influencing A/SU during pregnancy among AI/AN birthing people, with qualitative insights providing a deeper understanding of the interplay between prenatal A/SU, IPV, and adverse childhood experiences (ACEs) within the AI/AN community. Aim 1 revealed that across exposure to both punitive and treatment-oriented prenatal substance use policies, AI/AN birthing people had significantly greater odds of experiencing inadequate prenatal care and late prenatal care initiation compared to their NH-white counterparts. Exposure to punitive policies appeared to exacerbate the inadequacy of care for Indigenous birthing people compared to NH-white birthing people. Exposure to treatment policy was also found to be particularly beneficial within Indigenous populations leading to significantly more adequate care.Aim 2 revealed that Indigenous birthing people face significantly more structural/personal barriers and clinical/access barriers to prenatal care compared to NH-white people, but fewer financial/insurance barriers to prenatal care. Prenatal drug use exacerbated structural/personal as well as financial/access barriers to care for the AI/AN population. Interpersonal violence exacerbated structural/personal barriers to care for the NH-white birthing population. Aim 3 mixed methods results agreed that exposure to interpersonal violence, parental substance abuse, and multiple adverse childhood experiences was associated with increased risks of prenatal A/SU. Qualitative findings suggested that support, cultural values, Indigenous identity, and practice of traditions were all protective factors against prenatal A/SU. Lastly, one emergent qualitative finding reveled sub-themes of healthcare/Western medicine that exacerbated risks of prenatal A/SU among Indigenous birthing people.

Electronic reproduction.
Ann Arbor, Mich. :
ProQuest,
2024

Mode of access: World Wide Web

ISBN: 9798382630038Subjects--Topical Terms:

560998
Public health.
Subjects--Index Terms:

American IndiansIndex Terms--Genre/Form:

554714
Electronic books.

Alcohol and Substance Use Among American Indian/Alaska Native Birthing People : = A Mixed Methods Study of Punitive versus Treatment State Policies and Community Level Risk Factors.
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