Indigenous Determinants of Prenatal Substance Use

University Of North Dakota, Grand Forks ND

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Abstract

This application, “Indigenous Determinants of Prenatal Substance Use,” proposes using photovoice participatory action research (PAR) to identify community-defined, place-based factors that serve as protective and risk factors influencing prenatal substance use, based on the first-person perspectives of American Indian child-bearing adults. Drawing upon photo-based community-resonant knowledge, this study will develop community-prioritized recommendations for prenatal behavioral health practice strategies, contextualized by a scoping review of existing interventions developed for prenatal substance use. This proposal responds to the RFA of “the Indigenous Trauma and Resilience Research Center (ITRRC) Grant Program.” This study proposes to conduct primary PAR, using photovoice techniques, and to embed a scoping review within the investigation. The photovoice PAR—an innovative method of creating art-based, community-based knowledge—will be conducted to identify community-defined social determinants of health constructs of prenatal substance use among American Indian women with a recent history of pregnancy (Aim 1). A scoping review, an effective method for evidence and gap mapping, will be conducted to critically analyze existing interventions and prevention programs developed for American Indian women with prenatal substance use (Aim 2). This method is particularly suited for systematically analyzing how social, economic, and environmental characteristics are integrated as theories of change or target mechanisms in existing interventions. This evidence synthesis will contextualize the photovoice findings, particularly regarding practice implications and policy priority-setting, as directly recommended by American Indian participants.