Centering Historical Oppression in Prevention Research with Indigenous Peoples: Differentiating Substance Use, Mental Health, Family, and Community Outcomes

Abstract

The purpose of this pilot study was to understand how historical oppression relates to changes in outcomes for people who participate in the culturally grounded Weaving Healthy Families (WHF) program (i.e., alcohol and drug use, symptoms of anxiety, parenting practices, and communal mastery [CM]). This nonexperimental and longitudinal design used repeated measures regression analysis and generalized estimating equations (GEE) to examine postintervention changes according to reported levels of historical oppression among 24 participants in eight families. How do postintervention changes differ for WHF participants reporting lower and higher levels of historical oppression? Results indicated that participants reporting lower historic oppression reported greater postintervention improvements as indicated by declines in alcohol use, anxiety, and poor parental monitoring. All participants reported increases in CM, regardless of the level of historical oppression. Given historical oppression drives psychosocial conditions, such as substance abuse, mental health, and family challenges, settler colonial oppression must be addressed within social service interventions. Social service providers must work redress historical oppression rather than replicate them. The WHF program holds promise to center structural determinants in social service programs. Future inquiries assessing longitudinal changes in perceptions of historical oppression change and how they are associated with psychosocial outcomes are needed.

Keywords:

• Indigenous
• Native American
• prevention
• substance use and abuse
• anxiety
• parenting
• community resilience
• historical oppression
• interventions
• families
• social service provision

Acknowledgments

The authors thank the dedicated work and participation of the tribes and collaborators who contributed to this work. We thank Jennifer Lilly, Jessica Liddell, Hannah Knipp, Jennifer Martin, Tamela Solomon, Nikki Comby, Harold Comby, Patricia Haynes, Kathleen Ferris, Juannina Mingo, Dan Isaac, Clarissa Stewart, Mariah Lewis, and Jeremy Chickaway for their incredible commitment, time and energy devoted to the WHF Program. We also thank Dana Kingfisher, Emily Matt Salois, d’Shane Barnett, and all the staff at the All Nations Health Center in Missoula, Montana for their important contributions to the pilot program. We thank Charles R. Figley, Karina Walters, James Allen, and Tonette Krousel-Wood for their support and mentorship for this pilot program. We thank The National Association for Children of Addiction for the original program from which the WHF program was developed, and White Bison for introducing cultural components.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the National Institutes of Health.