Publications by authors named "Randall C Swaim"

Background: American Indian (AI) adolescents report earlier initiation and higher rates of cannabis and alcohol use compared to their non-AI peers. Simultaneous cannabis and alcohol (SCA) use is increasingly common. A primary goal of our research was to identify profiles of cannabis and alcohol use, including SCA use, among AI adolescents using latent class analysis (LCA).

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Background: Reservation-area American Indian (AI) youth use cannabis at significantly higher rates than their national counterparts. This discrepancy is concerning, as cannabis use-particularly heavy use-can negatively impact adolescents' health. Studies primarily use frequency to classify cannabis use intensity; however, frequency alone may not fully capture heterogenous patterns of use.

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Purpose: This study aims to examine a second-order latent variable of family functioning built from two established protective factors for American Indian (AI) youth, i.e. family cohesion and parental monitoring.

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Reservation-dwelling American Indian adolescents are at exceedingly high risk for cannabis use. Prevention initiatives to delay the onset and escalation of use are needed. The risk and promotive factors approach to substance use prevention is a well-established framework for identifying the timing and targets for prevention initiatives.

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Background: Past research has found significant nicotine use disparities for reservation-area American Indian adolescents when compared to national levels. However, adolescent nicotine use has changed markedly, with reduced smoking and rapid increases in nicotine vaping. This study presents 2021-2022 prevalence estimates of tobacco product use, perceived harm and availability for reservation-area American Indian youth, with comparisons to the Monitoring the Future (MTF) national study.

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Background: High cannabis use rates among American Indian (AI) adolescents necessitate the identification of factors that protect against early cannabis initiation.

Methods: Data collected from 279 AI middle school students attending reservation-based schools in 2018 and 2019 were analyzed. Three waves of data, with approximately 6 months between each, were used.

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Introduction: The relationship between perceived discrimination and risky drinking among American Indian (AI) youth is understudied, and the potential protective factors that may buffer this association are unknown. Therefore, the objective of this study was to examine protective factors across individual, family, school, peer, and cultural domains of the social ecology that might attenuate the relationship between perceived discrimination and risky drinking among AI adolescents.

Method: Data were from the Substance Use Among American Indian Youth Study (Swaim and Stanley, 2018, 2021).

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Reservation-area American Indian (AI) youth demonstrate higher rates of binge drinking (BD) than their non-AI peers. However, individual and school-level differences in BD disparities between reservation-area AI/non-AI female and male adolescents remain unexamined. This study applies an Intersectional framework to examine risk and protective factors of BD among reservation-area youth at the intersection of their sex and AI identities.

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Introduction: This study presents data from 2 population-based surveys of youth (reservation-area American Indian adolescents and U.S. adolescents) on self, family, and friend morbidity and changes in substance use and negative impacts during COVID-19.

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Background And Objectives: American Indian (AI) adolescents report higher rates of cannabis use than national US adolescents. Previous study examined interactive relationships between depressed affect and family factors on AI adolescent alcohol use. These factors have not been investigated for cannabis use.

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The COVID-19 pandemic has caused an unprecedented disruption to the lives of American Indian (AI) adolescents. While reservation-area AI youth already have a higher risk of substance use (SU) compared to their non-AI peers, COVID-19 stressors likely exacerbated this risk. However, COVID-19-specific and general resilience factors may have buffered against increased SU over the course of the pandemic.

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Importance: Impacts of COVID-19 on reservation-area American Indian youth are unknown and may be substantial owing to the significant COVID-19 morbidity and mortality experienced by American Indian populations.

Objective: To measure self-reported illness experiences and changes in psychosocial factors during the COVID-19 pandemic among reservation-area American Indian youth.

Design, Setting, And Participants: This cross-sectional study included a random sample of US schools on or near US Indian reservations during Spring 2021, stratified by region, with students in grades 6 to 12 completing cross-sectional online surveys.

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Reservation-dwelling American Indian adolescents are at exceedingly high risk for cannabis use. Prevention initiatives to delay onset and escalation of use are needed. School engagement and student's positive experiences at school have been identified as key promotive factors against cannabis use in the general population of adolescents, but little work has examined these factors among American Indian youth.

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Background: Solitary substance use, or using substances while alone, is common among adolescents but understudied. This is the first study to examine solitary substance use among American Indian (AI) adolescents. The objective was to examine correlates of solitary alcohol use and solitary cannabis use that occur within the individual, family, school, peer, and cultural domains of the social ecology.

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Be Under Your Own Influence (BUYOI) is a previously validated school-based intervention designed to delay adolescent substance use (SU) initiation. This study examined the effectiveness of a culturally-adapted version of BUYOI in delaying SU initiation among reservation-dwelling American Indian (AI) youth. Five reservation-based middle schools participated.

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American Indian (AI) youth residing on reservations report higher rates of marijuana use compared to national youth. Latent class analysis (LCA) was used to identify unique types of marijuana use among 2,884 AI high school students surveyed from 26 schools across six indigenous geographic regions. Predictors of class membership were then assessed using social, cultural, and individual measures relevant to adolescent substance use.

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To present data for opioid misuse among US reservation-based American Indian (AI) adolescents and to compare these data with national rates from Monitoring the Future (MTF). Data were from a national sample of 33 schools participating in a substance use epidemiological survey of reservation-based AI adolescents during 2018 and 2019. Participants were 8th-, 10th-, and 12th-grade AI students (n = 1592).

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Background: Prescription drug misuse (PDM) is a growing issue within the American Indian (AI) population, especially in younger populations.

Objectives: This study estimates relationships between PDM and early initiation (prior to 14 yrs) of cannabis use and alcohol intoxication for a national sample of AI and non-AI adolescents attending schools on or near reservations.

Method: Participants were 2580 students (50.

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Objective: There is limited research on the motives for engaging in cannabis use for American Indian (AI) youth. The purpose of this study was to explore the differences in cannabis use motives between White and AI youth.

Method: This study used data from youth living on or near reservations who currently use cannabis and identify as White (n = 156) or AI (n = 922).

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Opioid use among youth, particularly among American Indian (AI) youth, is rising, resulting in a large number of accidental overdoses and deaths. In order to develop effective prevention strategies, we need to use exploratory data analysis to identify previously unknown predictors of opioid use among youth living on or near reservations. The present study is an application of Machine Learning, a type of exploratory data analysis, to the Our Youth, Our Future epidemiological survey ( = 6482) to determine salient risk and protective factors for past 30-day opioid use.

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Substance use (SU) rates among American Indian (AI) adolescents have been greater than national rates for decades, with little progress made on reducing them. Reasons for this may include lack of evidence on which to base effective interventions, the uniqueness of this population, and the overall lack of attention that this population has received in reducing socioeconomic and health disparities. Moreover, there has been limited focus on understanding how positive individual characteristics may serve as protective factors for AI adolescents.

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Objectives: Determine potential mediating and moderating effects of self-esteem on the relationship between cultural identification and substance use among American Indian (AI) youth.

Methods: Anonymous surveys were administered to middle and high school AI students assessing levels of last month alcohol and marijuana use, cultural identification, and self-esteem. Structural equation modeling assessed potential mediating and moderating effects of self-esteem on the relationship between AI and white identification on alcohol and marijuana use.

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Objective: Some American Indians legally use hallucinogenic substances as part of religious and spiritual ceremonies. Research to date has either failed to differentiate spiritual versus recreational use or has categorized hallucinogen use in an "other drug" or "illegal drug" category. This approach could contribute to ineffectual models of prevention and treatment intervention and limit understanding of hallucinogen use in American Indian cultures.

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Research exploring American Indian (AI) youth drinking motives and their relation to negative outcomes is critical due to higher rates of alcohol use and early exposure to intoxication in the population. The purpose of this study is to explore classes of drinking motives as they relate to heavy episodic drinking, perceived discrimination, religious importance, ethnic identity, and ethnic pride. This study is part of an ongoing epidemiologic and etiologic investigation of substance use among AI youth drinkers living on or near reservations (n = 1,934, Mage = 15.

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Background And Objectives: Identical latent classes of substance use for 7 to 8 grade and 9 to 12 grade American Indian (AI) youth living on or near reservations suggest that patterns of substance use are established early among these youth. This study examines relationships of substance-related factors to latent class membership and whether these relationships differ by grade group.

Methods: In-school surveys were administered to 1503 7 to 8 grade and 1995 9 to 12 grade students from 46 schools on or near reservations during the 2009/2010 to 2012/2013 school years.

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