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Article ; Online: Cultural Factors and Alcohol Use in American Indian Adults: Results From a Culturally Tailored Contingency Management Intervention.

Herron, Jalene / Hirchak, Katherine A / Venner, Kamilla / Tofighi, Davood / McDonell, Michael G

2022 Volume 84, Issue 2, Page(s) 273–280

Abstract: Objective: American Indian and Alaska Native (AI/AN) populations experience greater health disparities in alcohol use outcomes compared with the general population. This secondary data analysis examines cultural factors related to alcohol use in ... ...

Abstract	Objective: American Indian and Alaska Native (AI/AN) populations experience greater health disparities in alcohol use outcomes compared with the general population. This secondary data analysis examines cultural factors related to alcohol use in reservation-based American Indian (AI) adults ( Method: Generalized linear mixed modeling was used to calculate odds ratios (ORs) for the repeated measure, biweekly urine tests of the biomarker, ethyl glucuronide (EtG), across 12 weeks. The relationships between alcohol use (abstinence [EtG < 150 ng/ml]) or heavy drinking [EtG > 500 ng/ml]) and culturally relevant protective (enculturation, years lived on the reservation) and risk factors (discrimination, historical loss, historical loss symptoms) were examined. Results: There was a negative association between enculturation and probability of submitting a heavy drinking urine sample (OR = 0.973; 95% CI [0.950, 0.996], Conclusions: Cultural factors (e.g., enculturation) may be important constructs to assess and incorporate into treatment planning with AI adults engaged in alcohol treatment.
MeSH term(s)	Adult ; Humans ; Male ; Alcohol Drinking/epidemiology ; American Indian or Alaska Native ; Behavior Therapy/methods ; Indians, North American ; Risk Factors ; Female
Chemical Substances	ethyl glucuronide (17685-04-0)
Language	English
Publishing date	2022-09-01
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2266450-6
ISSN	1938-4114 ; 1934-2683 ; 1937-1888 ; 0096-882X
ISSN (online)	1938-4114 ; 1934-2683
ISSN	1937-1888 ; 0096-882X
DOI	10.15288/jsad.21-00400
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Article ; Online: A scoping review of cultural adaptations of substance use disorder treatments across Latinx communities: Guidance for future research and practice.

Venner, Kamilla L / Hernandez-Vallant, Alexandra / Hirchak, Katherine A / Herron, Jalene L

Journal of substance abuse treatment

2022 Volume 137, Page(s) 108716

Abstract: Introduction: Much of the substance use disorder (SUD) treatment efficacy and effectiveness research is lacking consensus on which scientifically rigorous approach to employ for culturally adapting evidence-based treatments (EBTs) and evidence-based ... ...

Abstract	Introduction: Much of the substance use disorder (SUD) treatment efficacy and effectiveness research is lacking consensus on which scientifically rigorous approach to employ for culturally adapting evidence-based treatments (EBTs) and evidence-based preventions (EBPs) for SUDs among Latinx communities. The aim of this paper is to provide a scoping review of the literature on cultural adaptations of SUD treatment for Latinx communities. Methods: We examined the justifications for cultural adaptations, processes of adaptations, cultural adaptations described, and efficacy and effectiveness of culturally adapted SUD interventions. The study followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Inclusion criteria consisted of whether the intervention had been culturally adapted based upon an existing EBT or EBP for SUD. Through the search of four databases, expert knowledge and reviewing the reference list of applicable articles, 30 articles met inclusion criteria, which included 14 treatment or prevention outcome articles, one single group pre-post study article, and 15 methods papers on cultural adaptations. Justifications for cultural adaptations centered on SUD health inequities among Latinx populations. Results: Four research groups employed adaptation models to culturally tailor evidence-based interventions and most often used elements of community-based participatory research (CBPR). Using Bernal, Bellido, & Bonilla's (1995) Ecological Validity Framework of eight dimensions, the most common cultural adaptations centered on language, context, content, and persons. Efficacy trials with Latinx populations are nascent though growing and reveal: (1) significant time effects for EBTs and most EBPs, (2) superior SUD outcomes for culturally adapted EBTs compared to standard EBTs or other comparison conditions by three research groups, (3) significant prevention intervention effects by three research groups, and (4) significant cultural or social moderators by two groups suggesting Latinx with higher cultural identity, parental familism, or baseline discrimination improve significantly more in the culturally adapted EBTs. Conclusion: These findings suggest that the science of culturally adapting EBTs is improving in rigor with the use of models to guide the work and the conduct of clinical trials. Measurement of cultural and social variables allows for tests of moderation to understand for whom cultural adaptations are most effective. Future hybrid efficacy/effectiveness trials and implementation research should continue moving the science of cultural adaptation forward.
MeSH term(s)	Humans ; Parents ; Substance-Related Disorders/therapy
Language	English
Publishing date	2022-01-11
Publishing country	United States
Document type	Journal Article ; Review ; Systematic Review ; Research Support, N.I.H., Extramural
ZDB-ID	605923-5
ISSN	1873-6483 ; 0740-5472
ISSN (online)	1873-6483
ISSN	0740-5472
DOI	10.1016/j.jsat.2021.108716
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Article: Urban American Indian Adult Participation and Outcomes in Culturally Adapted and Mainstream Alcoholics Anonymous Meetings.

Tonigan, J Scott / Venner, Kamilla / Hirchak, Katherine A

Alcoholism treatment quarterly

2019 Volume 38, Issue 1, Page(s) 50–67

Abstract: Very little is known about American Indian (AI) adults' participation in Alcoholics Anonymous (AA) despite their elevated rates of negative sequelae due to heavy alcohol consumption and alcohol use disorders. This study sought to fill that gap and ... ...

Abstract	Very little is known about American Indian (AI) adults' participation in Alcoholics Anonymous (AA) despite their elevated rates of negative sequelae due to heavy alcohol consumption and alcohol use disorders. This study sought to fill that gap and examined the engagement in AA by urban Southwest AI (S-AI) adult problem drinkers and whether enculturation and acculturation accounted for type of AA attended (mainstream versus culturally adapted AA; CA-AA). Additionally, we compared three and six-month drinking outcomes of urban S-AI adults by type of meeting attended. Sixty-one urban S-AI adults were consented and assessed at baseline, three and six-months. We examined the association between frequency of AA attendance and differences between types of meetings attended regressed on the outcomes of proportion abstinent days and drinks per drinking day. Results indicate that AA attendance is the model approach and assists urban S-AI adults in reducing their drinking. Despite higher engagement among those attending both AA and CA-AA, this did not translate into differential AA-related benefit which speaks to the need for additional research to assist AI adults in effectively reducing their alcohol use.
Language	English
Publishing date	2019-06-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	798390-6
ISSN	1544-4538 ; 0734-7324
ISSN (online)	1544-4538
ISSN	0734-7324
DOI	10.1080/07347324.2019.1616512
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Article ; Online: Assessing Differences in the Availability of Opioid Addiction Therapy Options: Rural Versus Urban and American Indian Reservation Versus Nonreservation.

Hirchak, Katherine A / Murphy, Sean M

The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association

2016 Volume 33, Issue 1, Page(s) 102–109

Abstract: Background: Opioid misuse is a large public health problem in the United States. Residents of rural areas and American Indian (AI) reservation/trust lands represent traditionally underserved populations with regard to substance-use disorder therapy.: ... ...

Abstract	Background: Opioid misuse is a large public health problem in the United States. Residents of rural areas and American Indian (AI) reservation/trust lands represent traditionally underserved populations with regard to substance-use disorder therapy. Purpose: Assess differences in the number of opioid agonist therapy (OAT) facilities and physicians with Drug Addiction Treatment Act (DATA) waivers for rural versus urban, and AI reservation/trust land versus non-AI reservation/trust land areas in Washington State. Methods: The unit of analysis was the ZIP code. The dependent variables were the number of OAT facilities and DATA-waivered physicians in a region per 10,000 residents aged 18-64 in a ZIP code. A region was defined as a ZIP code and its contiguous ZIP codes. The independent variables were binary measures of whether a ZIP code was classified as rural versus urban, or AI reservation/trust land versus non-AI reservation/trust land. Zero-inflated negative binomial regressions with robust standard errors were estimated. Results: The number of OAT clinics in a region per 10,000 ZIP-code residents was significantly lower in rural versus urban areas (P = .002). This did not differ significantly between AI reservation/trust land and non-AI reservation/trust land areas (P = .79). DATA-waivered physicians in a region per 10,000 ZIP-code residents was not significantly different between rural and urban (P = .08), or AI reservation/trust land versus non-AI reservation/trust land areas (P = .21). Conclusions: It appears that the potential for Washington State residents of rural and AI reservation areas to receive OAT is similar to that of residents outside of those areas; however, difficulties in accessing therapy may remain, highlighting the importance of expanding health care insurance and providing support for DATA-waivered physicians.
MeSH term(s)	Addiction Medicine/statistics & numerical data ; Addiction Medicine/trends ; Adolescent ; Adult ; Female ; Geographic Mapping ; Health Services Accessibility/standards ; Humans ; Indians, North American/statistics & numerical data ; Male ; Middle Aged ; Opioid-Related Disorders ; Poisson Distribution ; Rural Population/statistics & numerical data ; Substance Abuse Treatment Centers/statistics & numerical data ; Substance Abuse Treatment Centers/utilization ; Substance-Related Disorders/therapy ; Urban Population/statistics & numerical data ; Washington
Language	English
Publishing date	2016-03-14
Publishing country	England
Document type	Journal Article
ZDB-ID	639160-6
ISSN	1748-0361 ; 0890-765X
ISSN (online)	1748-0361
ISSN	0890-765X
DOI	10.1111/jrh.12178
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Article: Assessing Differences in the Availability of Opioid Addiction Therapy Options: Rural Versus Urban and American Indian Reservation Versus Nonreservation

Hirchak, Katherine A / Sean M. Murphy

Journal of rural health. 2017 Jan., v. 33, no. 1

2017

Abstract: BACKGROUND: Opioid misuse is a large public health problem in the United States. Residents of rural areas and American Indian (AI) reservation/trust lands represent traditionally underserved populations with regard to substanceâuse disorder therapy. ... ...

Abstract	BACKGROUND: Opioid misuse is a large public health problem in the United States. Residents of rural areas and American Indian (AI) reservation/trust lands represent traditionally underserved populations with regard to substanceâuse disorder therapy. PURPOSE: Assess differences in the number of opioid agonist therapy (OAT) facilities and physicians with Drug Addiction Treatment Act (DATA) waivers for rural versus urban, and AI reservation/trust land versus nonâAI reservation/trust land areas in Washington State. METHODS: The unit of analysis was the ZIP code. The dependent variables were the number of OAT facilities and DATAâwaivered physicians in a region per 10,000 residents aged 18â64 in a ZIP code. A region was defined as a ZIP code and its contiguous ZIP codes. The independent variables were binary measures of whether a ZIP code was classified as rural versus urban, or AI reservation/trust land versus nonâAI reservation/trust land. Zeroâinflated negative binomial regressions with robust standard errors were estimated. RESULTS: The number of OAT clinics in a region per 10,000 ZIPâcode residents was significantly lower in rural versus urban areas (P = .002). This did not differ significantly between AI reservation/trust land and nonâAI reservation/trust land areas (P = .79). DATAâwaivered physicians in a region per 10,000 ZIPâcode residents was not significantly different between rural and urban (P = .08), or AI reservation/trust land versus nonâAI reservation/trust land areas (P = .21). CONCLUSIONS: It appears that the potential for Washington State residents of rural and AI reservation areas to receive OAT is similar to that of residents outside of those areas; however, difficulties in accessing therapy may remain, highlighting the importance of expanding health care insurance and providing support for DATAâwaivered physicians.
Keywords	agonists ; drug abuse ; health services ; insurance ; physicians ; rural areas ; rural health ; therapeutics ; urban areas ; Washington (state)
Language	English
Dates of publication	2017-01
Size	p. 102-109.
Publishing place	John Wiley & Sons, Ltd
Document type	Article
Note	JOURNAL ARTICLE
ZDB-ID	639160-6
ISSN	0890-765X
ISSN	0890-765X
DOI	10.1111/jrh.12178
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Lessons learned from statewide contingency management rollouts addressing stimulant use in the Northwestern United States.

Parent, Sara C / Peavy, K Michelle / Tyutyunnyk, Diana / Hirchak, Katherine A / Nauts, Tammera / Dura, Amy / Weed, Lora / Barker, Linda / McDonell, Michael G

Preventive medicine

2023 Volume 176, Page(s) 107614

Abstract: Increases in stimulant drug use (such as methamphetamine) and related deaths creates an imperative for community settings to adopt evidence-based practices to help people who use stimulants. Contingency management (CM) is a behavioral intervention with ... ...

Abstract	Increases in stimulant drug use (such as methamphetamine) and related deaths creates an imperative for community settings to adopt evidence-based practices to help people who use stimulants. Contingency management (CM) is a behavioral intervention with decades of research demonstrating efficacy for the treatment of stimulant use disorder, but real-world adoption has been slow, due to well-known implementation barriers, including difficulty funding reinforcers, and stigma. This paper describes the training and technical assistance (TTA) efforts and lessons learned for two state-wide stimulant-focused CM implementation projects in the Northwestern United States (Montana and Washington). A total of 154 providers from 35 community-based service sites received didactic training in CM beginning in 2021. Seventeen of these sites, ten of eleven in Montana (90.9%) and seven of 24 in Washington (29.2%), went on to implement contingency management programs adherent to their state's established CM protocol and received ongoing TTA in the form of implementation coaching calls. These findings illustrate that site-specific barriers such as logistical fit precluded implementation in more than 50% of the trained sites; however, strategies for site-specific tailoring within the required protocol aided implementation, resulting in successful CM program launch in a diverse cross-section of service sites across the states. The lessons learned add to the body of literature describing CM implementation barriers and solutions.
MeSH term(s)	Humans ; United States ; Substance-Related Disorders/therapy ; Central Nervous System Stimulants ; Washington ; Behavior Therapy/methods ; Methamphetamine
Chemical Substances	Central Nervous System Stimulants ; Methamphetamine (44RAL3456C)
Language	English
Publishing date	2023-07-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2023.107614
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Article ; Online: The Validity of the Short Inventory of Problems and Drinking Intensity among Urban American Indian Adults.

Hirchak, Katherine A / Tonigan, J Scott / Hernandez-Vallant, Alexandra / Herron, Jalene / Cloud, Violette / Venner, Kamilla L

Substance use & misuse

2021 Volume 56, Issue 4, Page(s) 501–509

Abstract: Background: American Indian (AI) adults have both high prevalence rates of alcohol abstinence and alcohol use disorders compared to non-Hispanic White adults. We investigated the applicability and validity of the Short Inventory of Problems (SIP) among ... ...

Abstract	Background: American Indian (AI) adults have both high prevalence rates of alcohol abstinence and alcohol use disorders compared to non-Hispanic White adults. We investigated the applicability and validity of the Short Inventory of Problems (SIP) among AI urban adults and the moderating effect of biological sex. Methods: AI adults from three Alcoholics Anonymous samples ( Results: Cronbach alphas of the SIP were similar between urban AI adults and the mainstream treatment-seeking population reported in the SIP manual. DPDD was a significant and positive predictor of all five SIP scales collected 9-months later. Higher PDA was significantly and negatively associated with later consequences, and all 5 SIP scales. Moderation tests indicated that the association between consequences and drinking intensity was stronger for AI females with fewer drinking days resulting in significantly fewer consequences for AI males relative to AI females. Conclusions: Findings highlight the acceptability of SIP as a measure to assess drinking related consequences among AI urban adults, with clinical implications related to alcohol use and sex. Further research is warranted to examine differential drinking related outcomes among AI men and women in addition to adaptations of the SIP that more fully capture the range of negative drinking consequences.
MeSH term(s)	Adult ; Alcohol Drinking/epidemiology ; Alcoholics Anonymous ; Alcoholism ; Female ; Humans ; Male ; Surveys and Questionnaires ; American Indian or Alaska Native
Language	English
Publishing date	2021-02-19
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1310358-1
ISSN	1532-2491 ; 1082-6084
ISSN (online)	1532-2491
ISSN	1082-6084
DOI	10.1080/10826084.2021.1883656
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Article ; Online: Coming together for something good: recommendations from a scoping review for dissemination and implementation science to improve indigenous substance use disorder treatment.

Hirchak, Katherine A / Oluwoye, Oladunni / Nadeau, Melanie / Richardson, Meenakshi / Bajet, Kelsey / Brigman, Mariah / Herron, Jalene L / Hernandez-Vallant, Alexandra / Vasquez, Angel / Pham, Cuong / Oliver, Karen Anderson / Baukol, Paulette / Webb, Kellie / Belone, Lorenda / McDonell, Michael G / Venner, Kamilla L / Campbell, Aimee N C

Frontiers in public health

2023 Volume 11, Page(s) 1265122

Abstract: Introduction: Dissemination and Implementation (D&I) science is growing among Indigenous communities. Indigenous communities are adapting and implementing evidence-based treatments for substance use disorders (SUD) to fit the needs of their communities. ...

Abstract	Introduction: Dissemination and Implementation (D&I) science is growing among Indigenous communities. Indigenous communities are adapting and implementing evidence-based treatments for substance use disorders (SUD) to fit the needs of their communities. D&I science offers frameworks, models, and theories to increase implementation success, but research is needed to center Indigenous knowledge, enhancing D&I so that it is more applicable within Indigenous contexts. In this scoping review, we examined the current state of D&I science for SUD interventions among Indigenous communities and identified best-practice SUD implementation approaches. Methods: PubMed and PsycINFO databases were queried for articles written in English, published in the United States, Canada, Australia, and New Zealand. We included key search terms for Indigenous populations and 35 content keywords. We categorized the data using the adapted and extended Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework that emphasizes equity and sustainability. RE-AIM has also been used as a primary model to consistently identify implementation outcomes. Results: Twenty articles were identified from the original unduplicated count of over 24,000. Over half the articles discussed processes related to Reach, Adoption, and Implementation. Effectiveness was discussed by 50% of the studies ( Conclusion: Finding indicated a need to prioritize Indigenous methods to culturally center, re-align and adapt Western treatments and frameworks to increase health equity and improve SUD treatment outcomes. Utility in the use of the modified RE-AIM and the continued modification for Indigenous communities was also noted.
MeSH term(s)	Humans ; United States ; Implementation Science ; Substance-Related Disorders/therapy ; Canada ; Australia ; New Zealand
Language	English
Publishing date	2023-10-17
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, N.I.H., Extramural
ZDB-ID	2711781-9
ISSN	2296-2565 ; 2296-2565
ISSN (online)	2296-2565
ISSN	2296-2565
DOI	10.3389/fpubh.2023.1265122
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Article ; Online: The urgent need for contingency management among Tribal communities in the United States: Considerations for implementation, policy, and sovereignty.

Hirchak, Katherine A / Echo-Hawk, Holly / Parent, Sara / Peavy, K Michelle / Webb, Kellie / Bajet, Kelsey / Richardson, Meenakshi / Granbois, Alexandria / Herron, Jalene L / Catron, Krista / King, Keli / Parsells, Ed / Freese, Thomas E / Thomas, Lisa Rey / Rawson, Richard / Clark, H Westley / Roll, John / McDonell, Michael G

Preventive medicine

2023 Volume 176, Page(s) 107662

Abstract: In two randomized controlled trials, culturally adapted contingency management (i.e., incentives provided for substance-negative urine samples) was associated with reduced alcohol and drug use among geographically diverse American Indian and Alaska ... ...

Abstract	In two randomized controlled trials, culturally adapted contingency management (i.e., incentives provided for substance-negative urine samples) was associated with reduced alcohol and drug use among geographically diverse American Indian and Alaska Native (AI/AN) adults. In response to interest in contingency management from other Tribal and AI/AN communities, our research team in collaboration with AI/AN behavioral health experts, translated the research into practice with new AI/AN community partners. Tenets of community-based participatory research were applied to develop, pilot, and refine contingency management training and implementation tools, and identify implementation challenges. In partnership with the AI/AN communities, four members of the university team developed tools and identified implementation and policy strategies to increase the successful uptake of contingency management in each location. Through our collaborative work, we identified policy barriers including inadequate federal funding of contingency management incentives and a need for further clarity regarding federal anti-kickback regulations. Adoption of contingency management is feasible and can strengthen Tribal communities' capacity to deliver evidence-based substance use disorder treatments to AI/AN people. Unfortunately, non-evidence-based limits to the use of federal funding for contingency management incentives discriminate against AI/AN communities. We recommend specific federal policy reforms, as well as other practical solutions for Tribal communities interested in contingency management.
MeSH term(s)	Adult ; Humans ; Behavior Therapy ; Policy ; United States ; American Indian or Alaska Native ; Culturally Competent Care ; Alcoholism/prevention & control ; Substance-Related Disorders/prevention & control
Language	English
Publishing date	2023-08-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	184600-0
ISSN	1096-0260 ; 0091-7435
ISSN (online)	1096-0260
ISSN	0091-7435
DOI	10.1016/j.ypmed.2023.107662
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Article ; Online: Variations in national availability of waivered buprenorphine prescribers by racial and ethnic composition of zip codes.

Hirchak, Katherine A / Amiri, Solmaz / Kordas, Gordon / Oluwoye, Oladunni / Lyons, Abram J / Bajet, Kelsey / Hahn, Judith A / McDonell, Michael G / Campbell, Aimee N C / Venner, Kamilla

Substance abuse treatment, prevention, and policy

2022 Volume 17, Issue 1, Page(s) 41

Abstract: Background: Opioid overdose remains a public health crisis in diverse communities. Between 2019 and 2020, there was an almost 40% increase in drug fatalities primarily due to opioid analogues of both stimulants and opioids. Medications for opioid use ... ...

Abstract	Background: Opioid overdose remains a public health crisis in diverse communities. Between 2019 and 2020, there was an almost 40% increase in drug fatalities primarily due to opioid analogues of both stimulants and opioids. Medications for opioid use disorder (MOUD; e.g., buprenorphine) are effective, evidence-based treatments that can be delivered in office-based primary care settings. We investigated disparities in the proportion of national prescribers who have obtained a waiver issued to prescribe MOUD by demographic characteristics. Methods: Data for the secondary data analyses were obtained from the Drug Enforcement Administration that maintains data on waivered MOUD prescribers across the US. Proportion of waivered prescribers were examined by ZIP code, race and ethnicity composition, socioeconomic status, insurance, and urban-rural designation using generalized linear mixed effects models. Results: Compared with predominantly Non-Hispanic White ZIP codes, other racially and ethnically diverse areas had a higher proportion of waivered buprenorphine prescribers. Differences in prescriber availability between predominant racial group was dependent on rurality based on the interaction found in our fitted model. In metropolitan areas, we found that predominantly Non-Hispanic White ZIP codes had a lower rate of waivered prescribers compared to predominantly Black/African American ZIP codes. Conclusions: Our findings suggest that among AI/AN and Black/African American neighborhoods, availability of waivered prescribers may not be a primary barrier. However, availability of waivered prescribers and prescribing might potentially be an obstacle for Hispanic/Latinx and rural communities. Additional research to determine factors related to improving MOUD availability among diverse communities therefore remains vital to advancing health equity.
MeSH term(s)	Analgesics, Opioid/therapeutic use ; Buprenorphine/therapeutic use ; Ethnicity ; Humans ; Opioid-Related Disorders/drug therapy ; Rural Population
Chemical Substances	Analgesics, Opioid ; Buprenorphine (40D3SCR4GZ)
Language	English
Publishing date	2022-05-25
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2222956-5
ISSN	1747-597X ; 1747-597X
ISSN (online)	1747-597X
ISSN	1747-597X
DOI	10.1186/s13011-022-00457-3
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