We conducted an a priori sampling approach using a purposive sampling method. Our two study questions are as follows: 1) What are common family-child engagement activities that families with young children with prenatal drug exposure participate in across four domains (cultural, community, outdoors, home)? 2) What are common outcomes, barriers, and supports to these activities that impact participation among this population? The study goal was to identify barriers and supports to family-child engagement activities and positive outcomes in children residing in one Tribal Nation within northwestern Montana with established community-wide supports to promote family and community connectedness.
These study findings inform the current study in that we also will measure similar interventions that show promising child outcomes particularly among Native American children with a history of trauma residing in an Indigenous community. For example, children born to mothers with a history of alcohol, marijuana, or illicit substances demonstrated greater improvements in emotional and behavioral outcomes after receiving a culturally congruent home-visiting intervention compared to their counterparts that had mothers without a substance use history.
We assert resistance occurs when stressful events do not happen at all and we can avoid the need to always be resilient. Resilience provides a buffer against stressful life events by preventing or attenuating psychological distress. Although these statistics and outcomes are important public health concerns warranting attention, it is important also to share that Indigenous communities are a place of resilience and resistance to historical and contemporary traumas. Early intervention for children with prenatal substance exposure with the goal of mitigating long-term consequences is warranted. The mismatch of the highly stimulating prenatal environment (i.e., in utero drug exposure] with the low stimulating postnatal environment (i.e., absence of drug, parental neglect) was confirmed in that there was a significant positive association between prenatal drug exposure and internalizing and externalizing problem behaviors. adapted this programming theory to children with prenatal exposure to methamphetamine or cocaine and risk of externalizing and internalizing problem behaviors. These long-term behavioral consequences among children born with prenatal drug exposure can be partly explained by the “fetal origins hypothesis”, which is a programming theory that posits having non-matching prenatal and postnatal environments leads to negative health consequences. These can result in complex health care needs for the child and associated economic burdens placed on families and communities. Prenatal methamphetamine and opioid exposure are associated with neurobehavioral deficits in long-term learning and memory and externalizing (e.g., aggression, hyperactivity, disruptive) and internalizing (e.g., anxious, withdrawn, depressed) behaviors. The public health implications include pregnancy complications requiring prolonged hospital stays, physical risk to both moms and babies, and ultimately risk of death to both. Native American pregnant women are nearly six times more likely to have opioid use disorder compared to their non-Hispanic black counterparts.
Opioid and poly-drug use among pregnant women is an increasing epidemic. However, we do provide access to the semi-structure interview tool that would support replication of this study. Due to these restrictions, we cannot allow third-party access to the raw data.
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Stacey Sherwin at The collected qualitative data contain the following sensitive information: (i) identifies or could reasonably be used to identify any individual participant (ii) contains sensitive community and cultural traditional information (iii) substance use during pregnancy is a sensitive topic and requires additional safeguards (e.g., see “Title 42 Code of Federal Regulations Part 2”) to protect participant confidentiality and, (iv) participants may also be patients with an active substance use disorder (SUD) and are therefore a protected class with extra regulations under the Health Insurance Portability and Accountability Act (HIPAA) to protect disclosure of individuals diagnosed with SUD. For additional information, please contact the SKC IRB Chair, Dr. Data restrictions are imposed by the Salish Kootenai College Institutional Review Board (SKC IRB). The study data belong to the Confederated Salish and Kootenai Tribes.
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