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
APA StyleKemp, C. G., Chambers, R., Larzelere, F., Lee, A., Pinal, L. C., Slimp, A. M., & Tingey, L. (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(7), 4283. https://doi.org/10.3390/ijerph19074283