Utilization of the Transtheoretical Model to Determine the Qualitative Impact of a Tribal FASD Prevention Program

Olivia Lowrey, Kaitlyn Ciampaglio, Jamie L. Messerli, Jessica D. Hanson

Research output: Contribution to journalArticlepeer-review

Abstract

Alcohol consumption during pregnancy can lead to damaging effects on an infant’s health, including fetal alcohol spectrum disorders. Project Changing High-risk alcOhol use and Increasing Contraception Effectiveness Study (CHOICES), a program developed to reduce alcohol-exposed pregnancies through decreased alcohol consumption and increased birth control use, has been implemented with success in a variety of populations. The CHOICES program was structured to align with the transtheoretical model (Stages of Change), a popular public health model. Although studies have described the Stages of Change in the context of a variety of health behaviors, none have addressed the qualitatively distinct characteristics of each stage in the context of American Indian (AI) women’s alcohol and birth control use. A framework analysis of 203 participants’ written responses during their experience in the Oglala Sioux Tribe (OST) CHOICES Program was conducted. As a conceptual framework, the transtheoretical model of behavior change was applied to the participants’ experiences, with two staff reading the open-ended responses and coding based on the stage of change. Participants’ responses suggest qualitatively distinct stages as well as a progression through the stages for both behaviors during the course of the program. Many participants mentioned their children, education, and work as inspiration to decrease their unhealthy behaviors. Common barriers to behavior change were found across both behaviors. The open-ended responses uncover common themes in the experiences of the participants. These results can help inform future programs which hope to address the needs of AI communities.

Original languageEnglish (US)
JournalSAGE Open
Volume9
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Bibliographical note

Funding Information:
Special thanks to Susan Pourier who helped lead the development and implementation of the Oglala Sioux Tribe (OST) Changing High-risk alcOhol use and Increasing Contraception Effectiveness Study (CHOICES) Program. Thanks also to Jacque Jacobs-Knight, Amy Willman, Jessica Holsworth, Jessica Gromer, Katana Jackson, and Christina Janis. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this project comes from an Indian Health Service (IHS) cooperative agreement, award number H1UIHS300419; from the National Institutes of Health (NIH), National Institute on Minority Health and Health Disparities, award number 1R24MD008087; and from National Science Foundation (NSF) Research Experiences for Undergraduates (REU), award number 1559899 from the Directorate for Social, Behavioral, and Economic Sciences, Office of Multidisciplinary Activities, National Science Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the IHS, NIH, or NSF.

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Funding for this project comes from an Indian Health Service (IHS) cooperative agreement, award number H1UIHS300419; from the National Institutes of Health (NIH), National Institute on Minority Health and Health Disparities, award number 1R24MD008087; and from National Science Foundation (NSF) Research Experiences for Undergraduates (REU), award number 1559899 from the Directorate for Social, Behavioral, and Economic Sciences, Office of Multidisciplinary Activities, National Science Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the IHS, NIH, or NSF.

Publisher Copyright:
© The Author(s) 2019.

Keywords

  • American Indian health
  • alcohol consumption
  • alcohol-exposed pregnancies
  • birth control
  • transtheoretical model

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