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
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Randomization and Masking
2.3. Intervention
2.4. Control Condition
2.5. Data Collection and Follow-Up
2.6. Outcomes
2.7. Moderators
2.8. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Overall | Control | Intervention | p | % Missing | |
---|---|---|---|---|---|
n | 301 | 151 | 150 | ||
Age 35–55 years (%) | 120 (40.0) | 63 (42.0) | 57 (38.0) | 0.56 | 0.3 |
Women (%) | 140 (46.5) | 71 (47.0) | 69 (46.0) | 0.95 | 0 |
Not Married/Cohabitating (%) | 178 (63.6) | 85 (60.7) | 93 (66.4) | 0.39 | 7.0 |
Have Children (%) | 226 (75.3) | 114 (76.0) | 112 (74.7) | 0.89 | 0.3 |
High School Diploma or GED (%) | 149 (50.5) | 79 (54.1) | 70 (47.0) | 0.27 | 2.0 |
Currently Employed (%) | 27 (9.1) | 14 (9.5) | 13 (8.7) | 0.96 | 1.3 |
Depressive Symptoms (%) | 91 (32.6) | 43 (31.6) | 48 (33.6) | 0.83 | 7.3 |
Ever Experienced Physical Violence (%) | 82 (31.3) | 43 (32.8) | 39 (29.8) | 0.69 | 13.0 |
Ever Experienced Sexual Violence (%) | 28 (11.6) | 17 (13.9) | 11 (9.2) | 0.34 | 19.6 |
Binge Drinking in Prior Three Months (%) | 215 (82.7) | 103 (79.8) | 112 (85.5) | 0.3 | 13.6 |
Marijuana Use in Prior Three Months (%) | 106 (40.3) | 58 (43.6) | 48 (36.9) | 0.327 | 12.6 |
Other Drug Use in Prior Three Months (%) | 68 (29.4) | 38 (34.2) | 30 (25.0) | 0.16 | 23.3 |
New Partner and Unprotected Sex in Prior Three Months (%) | 68 (26.2) | 36 (28.1) | 32 (24.2) | 0.57 | 13.6 |
Binge Drinking or Other Drug Use, and New Partner and Unprotected Sex in Prior Three Months (%) | 60 (23.3) | 33 (25.8) | 27 (20.9) | 0.44 | 14.6 |
Binge Drinking or Other Drug Use | Unprotected Sex Acts | Higher Risk Sexual Behavior | STI Screening | |||||
---|---|---|---|---|---|---|---|---|
3 m | 6 m | 3 m | 6 m | 3 m | 6 m | 3 m | 6 m E * | |
RD [95% CI] | RD [95% CI] | β [95% CI] | β [95% CI] | RD [95% CI] | RD [95% CI] | RD [95% CI] | RD [95% CI] | |
Primary Effects | ||||||||
Control | -- | -- | -- | -- | -- | -- | -- | -- |
Intervention | −0.03 [−0.15, 0.09] | 0.04 [−0.09, 0.17] | −3.49 [−12.24, 5.25] | −6.25 [−15.73, 3.22] | 0.05 [−0.1, 0.2] | 0.04 [−0.11, 0.18] | -- | 0.14 [0.02, 0.27] |
Moderators | ||||||||
Age | ||||||||
18−34 years | -- | -- | -- | -- | -- | -- | -- | -- |
35−55 years | −0.03 [−0.25, 0.2] | −0.16 [−0.41, 0.09] | −6.19 [−24.34, 11.95] | −6.75 [−26.17, 12.68] | 0.15 [−0.17, 0.46] | 0.1 [−0.18, 0.37] | -- | 0.11 [−0.15, 0.36] |
Gender | ||||||||
Male | -- | -- | -- | -- | -- | -- | -- | -- |
Female | 0 [−0.24, 0.23] | −0.19 [−0.44, 0.06] | 13.56 [−3.8, 30.92] | 14.08 [−4.85, 33.01] | 0.16 [−0.14, 0.45] | 0.09 [−0.2, 0.38] | -- | 0.12 [−0.13, 0.38] |
Marital Status | ||||||||
Married or Cohabitating | -- | -- | -- | -- | -- | -- | -- | -- |
Not Married or Cohabitating | −0.15 [−0.39, 0.08] | 0.11 [−0.16, 0.38] | 3.28 [−17.52, 24.09] | 23.24 [1.18, 45.31] | −0.14 [−0.45, 0.17] | 0.31 [0.01, 0.61] | -- | 0.1 [−0.17, 0.37] |
Children | ||||||||
None | -- | -- | -- | -- | -- | -- | -- | -- |
Any | 0.17 [−0.15, 0.49] | 0.01 [−0.31, 0.32] | −8.7 [−30.72, 13.32] | −6.61 [−30.37, 17.15] | 0.23 [−0.07, 0.53] | 0.18 [−0.14, 0.5] | -- | 0.19 [−0.1, 0.47] |
Education | ||||||||
Less than high school | -- | -- | -- | -- | -- | -- | -- | -- |
High school graduate or GED | −0.13 [−0.36, 0.11] | −0.28 [−0.55, −0.02] | −4.24 [−22.4, 13.91] | −9.46 [−28.46, 9.54] | 0.13 [−0.16, 0.43] | 0.25 [−0.04, 0.53] | -- | 0.17 [−0.09, 0.44] |
Employment | ||||||||
Not employed | -- | -- | -- | -- | -- | -- | -- | -- |
Employed | −0.21 [−0.71, 0.29] | 0.05 [−0.37, 0.48] | −0.66 [−37.81, 36.48] | 10.38 [−16.02, 36.78] | −0.57 [−1, −0.14] | −0.18 [−0.68, 0.33] | -- | −0.09 [−0.51, 0.34] |
Depressive Symptoms | ||||||||
None | -- | -- | -- | -- | -- | -- | -- | -- |
Any | −0.22 [−0.45, 0] | −0.03 [−0.31, 0.24] | −1.99 [−22.43, 18.45] | −25.96 [−49.4, −2.51] | 0.24 [−0.07, 0.55] | 0.39 [0.09, 0.68] | -- | 0.1 [−0.2, 0.4] |
Physical violence | ||||||||
None | -- | -- | -- | -- | -- | -- | -- | -- |
Ever | −0.09 [−0.37, 0.19] | 0.12 [−0.15, 0.39] | 0.23 [−21.4, 21.86] | 8.33 [−14.94, 31.61] | −0.13 [−0.46, 0.21] | −0.18 [−0.5, 0.13] | -- | 0.17 [−0.13, 0.48] |
Sexual violence | ||||||||
None | -- | -- | -- | -- | -- | -- | -- | -- |
Ever | −0.36 [−0.74, 0.02] | −0.31 [−0.71, 0.09] | −10.15 [−39.7, 19.4] | −11.85 [−49.33, 25.64] | −0.04 [−0.44, 0.35] | 0.02 [−0.39, 0.42] | -- | −0.16 [−0.63, 0.31] |
Binge drinking | ||||||||
No | -- | -- | -- | -- | -- | -- | -- | -- |
Yes | -- | -- | −2.01 [−17.8, 13.78] | 3.74 [−20.83, 28.3] | −0.05 [−0.43, 0.32] | 0.01 [−0.35, 0.37] | -- | 0.01 [−0.38, 0.39] |
Marijuana use | ||||||||
No | -- | -- | -- | -- | -- | -- | -- | -- |
Yes | 0.09 [−0.16, 0.35] | 0.1 [−0.17, 0.37] | −2.59 [−22.01, 16.83] | −5.02 [−26, 15.96] | 0.06 [−0.25, 0.37] | 0.13 [−0.18, 0.44] | -- | 0 [−0.29, 0.29] |
Other drug use | ||||||||
No | -- | -- | -- | -- | -- | -- | -- | -- |
Yes | -- | -- | −17.14 [−39.28, 4.99] | −8.77 [−33.92, 16.39] | 0.25 [−0.11, 0.61] | −0.01 [−0.39, 0.37] | -- | −0.04 [−0.38, 0.3] |
New partner and unprotected sex | ||||||||
No | -- | -- | -- | -- | -- | -- | -- | -- |
Yes | 0.02 [−0.22, 0.26] | 0.16 [−0.11, 0.43] | −3.58 [−24.96, 17.8] | −1.88 [−23.59, 19.83] | -- | -- | -- | 0.17 [−0.13, 0.48] |
Binge drinking or other drug use, and new partner/unprotected sex | ||||||||
No | -- | -- | -- | -- | -- | -- | -- | -- |
Yes | -- | -- | −3.14 [−25.56, 19.28] | −5.24 [−26.8, 16.33] | -- | -- | -- | 0.2 [−0.12, 0.52] |
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Kemp, C.G.; Chambers, R.; Larzelere, F.; Lee, A.; Pinal, L.C.; Slimp, A.M.; Tingey, L. 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. Int. J. Environ. Res. Public Health 2022, 19, 4283. https://doi.org/10.3390/ijerph19074283
Kemp CG, Chambers R, Larzelere F, Lee A, Pinal LC, Slimp AM, Tingey L. 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. International Journal of Environmental Research and Public Health. 2022; 19(7):4283. https://doi.org/10.3390/ijerph19074283
Chicago/Turabian StyleKemp, Christopher G., Rachel Chambers, Francene Larzelere, Angelita Lee, Laura C. Pinal, Anna M. Slimp, and Lauren Tingey. 2022. "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" International Journal of Environmental Research and Public Health 19, no. 7: 4283. https://doi.org/10.3390/ijerph19074283