“But Problems Dwell so the Urge Is Constant…” Qualitative Data Analysis of the OST CHOICES Program

Umit Shrestha, Tess L. Weber, Jessica D. Hanson

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Fetal alcohol spectrum disorders are a major public health concern including among American Indian (AI)/Alaska Native (AN) communities. Various studies have demonstrated higher alcohol consumption among AI/AN women during pregnancy compared with other groups. This study intends to understand the milieu within which such consumption patterns flourish. The study utilizes qualitative and quantitative data from the Oglala Sioux Tribe (OST) CHOICES Program, a tribally run public health program that aims to reduce alcohol-exposed pregnancy preconceptually in AI women. Methods: Alcohol consumption pattern (n = 264) is analyzed using descriptive statistics. Consumption patterns included average drinks consumed daily, their choice of drinks (beer, whiskey, wine, etc.), how much money participants were spending on alcohol and amount of calories consumed from alcohol. Qualitative data analysis included open coding of data from decisional balance exercise of the CHOICES program that looked at good things and not so good things about participants’ drinking. Results: Women reported drinking an average of 12 drinks daily, ranging between 1 and 86. Women drinking at home spent a median of $4,320 and $12,960 if drinking at a bar. A median of 1,200 calories per day from alcohol was reported. More women reported drinking beer compared with other types of alcohol within a domestic setting. Qualitative data analysis identified positive and negative aspects of drinking among the participants of OST CHOICES Program. Positive aspects included escaping from problems, socializing, and relaxation. Negative aspects included impact on families and domestic violence. Conclusions: While understanding their milieu, our study also unraveled different struggles (such as violence, peer pressure, financial burden, and depression) encountered by Native women in their daily lives. According to the participants, positive aspects of drinking outweigh the negative aspects and they viewed their drinking as a solution and not a problem.

Original languageEnglish (US)
Pages (from-to)1807-1814
Number of pages8
JournalAlcoholism: Clinical and Experimental Research
Issue number9
StatePublished - Sep 2018
Externally publishedYes

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and publication of this article. Funding for this project comes from an Indian Health Service cooperative agreement, award number H1UIHS300419; and from the National Institutes of Health, award numbers 1R24MD008087 and 5P20GM121341.

Publisher Copyright:
© 2018 by the Research Society on Alcoholism


  • Alaska Native
  • Alcohol
  • American Indian
  • CHOICES Intervention
  • Fetal Alcohol Syndrome Disorder
  • Qualitative
  • Women


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