The Fort Peck Substance Abuse and Resilience Project
Map by Kristen Drumheller
American Indians face significant disparities in the incidence of substance abuse across the United States (CDC, 2014), as well as disproportionately high frequency of related health risks such as depression, suicide, and domestic violence. In Montana, substance-related problems among American Indians are even more pronounced than in other states, according to the Montana Department of Public Health and Human Services.
The Fort Peck Reservation in northeastern Montana is representative of these particular trends. Alcohol abuse and an alarming rise in methamphetamine use are two of the most pressing health challenges in the reservation’s communities.
The objective of the Fort Peck Substance Abuse and Resilience Project is to understand local cultural conceptualizations of substance abuse problems and resiliency among the Assiniboine and Sioux tribes. The project examines individual, family, community, and sociocultural factors contributing to disparities in substance abuse problems, as well as factors associated with resilience and recovery. Researchers use a mixed-methods approach grounded in community-based participatory research and the socioecological model (Sallis et al., 2006; Stokols, 1996).
Phase 1 of the project has involved interviews with a wide range of community members: some who have never used alcohol or drugs, some in long-term recovery, and some who are trying to quit. Among this broad sample, researchers hope to assess the general attitudes and beliefs surrounding substance use rather than individual stories. Phase 2 will focus on a particular subset of the population through quantitative surveys that build on earlier results.
Ultimately, project collaborators will use the findings to develop sustainable public health interventions to reduce the disease burden of substance abuse on the reservation. With that end in mind, the specific aims of the project are:
- Aim 1: To build positive, respectful, trusting, and sustainable relationships among Montana State University researchers, Fort Peck Community College researchers, and Fort Peck community members and organizations.
- Aim 2: To identify social and cultural norms surrounding substance abuse at Fort Peck, including associated risk and protective factors.
- Aim 3: To examine interrelationships between individual, family, community, and sociocultural variables and their association with substance use behavior and efforts to change.
- Aim 4: To pilot-test culturally relevant assessment instruments and data collection methods.
- Aim 5: To develop and theater-test intervention strategies that integrate findings from Aims 2-4 with empirically supported best practices from psychology and public health.
Selected Project Accomplishments to Date
- Established trusting, equitable relationships with tribal members and leaders at the Fort Peck Indian Reservation, as well as partners at Fort Peck Community College, including co-investigator Paula FireMoon.
- Participated in community events, including the State of the Reservation Summit, the Trauma & Resilience Symposium, and the Buffalo Summit.
- Assembled a Community Advisory Board (CAB) and hold regular meetings. The CAB plays an integral role in all aspects of the research, including participant recruitment, measurement and data collection, data analysis and interpretation, dissemination of study findings, and development and pilot-testing of a culturally grounded intervention.
- Secured IRB approval from both the tribal IRB and the MSU IRB.
- Conducted 42 key informant interviews, began data analysis, and discussed early findings with the Community Advisory Board and the community at large.
- UP NEXT: Initiate a quantitative needs assessment to guide development of the intervention.
Related Publications and Presentations (Selected)
Gonzalez, V. M., & Skewes, M. C. (2016). Association of the firewater myth with drinking behavior among American Indian and Alaska Native college students. Psychology of Addictive Behaviors. 30(8): 838-849.
Skewes, M. C., Gardner, S. A., Salois, E. M., & FireMoon, P. (2016). Community Based Participatory Research to address substance abuse in a rural reservation community. Presentation at the American Public Health Association Annual Meeting, Denver, CO.
Skewes, M. C., Gardner, S. A., Salois, E. M., & FireMoon, P. (2016). Historical trauma and substance abuse in American Indian communities. Poster presentation at the American Public Health Association Annual Meeting, Denver, CO.
Skewes, M. C., & Lechuga, J. (chairs) (2016). Research on sensitive topics with ethnic minority communities. Symposium presented at the American Psychological Association Division 45 (Psychological Study of Culture, Ethnicity, and Race) Biannual Meeting, Palo Alto, CA.
Skewes, M. C., Gardner, S. A., Salois, E. M., & FireMoon, P. (2016). You have to know who you are: Identity and health. Presentation at the American Psychological Association Division 45 (Psychological Study of Culture, Ethnicity, and Race) Biannual Meeting, Palo Alto, CA.
Skewes, M. C. (2016). Beyond the firewater myth: Alcohol research with American Indian communities. Presentation at the American Psychological Association Division 45 (Psychological Study of Culture, Ethnicity, and Race) Biannual Meeting, Palo Alto, CA.
Skewes, M. C., & Lechuga, J. (2016). Communities in the driver’s seat: Partnering for better health. Roundtable discussion at the American Psychological Association Division 45 (Psychological Study of Culture, Ethnicity, and Race) Biannual Meeting, Palo Alto, CA.
Skewes, M. C., Blow, J. A., & Cooper, T. V. (2016). Perspectives on addictive behaviors: Harm reduction and ethnic minority psychology. Social Issues in Living Color: Challenges and Solutions from the Perspective of Ethnic Minority Psychology.
Gonzalez, V. M., & Skewes, M. C. (2016). Depression and suicide from the perspective of ethnic minority psychology. Social Issues in Living Color: Challenges and Solutions from the Perspective of Ethnic Minority Psychology.
Dr. Skewes has worked on the Fort Peck Reservation since 2014. Prior to that she worked in Alaska, studying substance use among college students—a subject she still examines, among others, in her REACH Lab at MSU.
Even with Skewes’s extensive experience studying smoking, drinking, and other addictive behaviors, she was surprised to find so many people at Fort Peck in recovery against all apparent odds—such as individuals recovering from methamphetamine addiction who live around current users and still somehow manage to stay clean. “I can’t even conceive how they can do that,” she says. “There’s some resilience and strength that people there have, so I’m trying to understand what that is.”
To Learn More
Read more about the project in this excerpt from the Spring 2016 CAIRHE Newsletter.
Watch Monica Skewes as a guest on the Montana Television Network program Face the State (aired October 23, 2016), where she discussed addiction in Montana along with Mike McGrath, chief justice of the Montana Supreme Court.