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

Christopher G. Kemp, Rachel Chambers, Francene Larzelere, Angelita Lee, Laura C. Pinal, Anna M. Slimp and Lauren Tingey
Additional contact information
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

IJERPH, 2022, vol. 19, issue 7, 1-11

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.

Keywords: binge substance use; sexual risk; Native American; indigenous; moderators (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/7/4283/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/7/4283/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:7:p:4283-:d:786367

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().