Adult Basic Education (ABE) in the United States is an important tool for underrepresented and underserved communities to achieve the goal of high school graduation following noncompletion of K-12 education. Largely in urban settings, ABE centers serve millions of students annually, especially historically and contemporarily marginalized groups. ABE provides critical resources and skills to meet the educational needs of diverse peoples seeking to advance their station in life. ABE centers may serve students with potentially traumatic events (PTE), diagnosable trauma, and related poorer outcomes. Alarmingly, a paucity of research exists that examines the presence of PTEs for ABE students, particularly people and womgen of color. In the present research, the Patient Health Questionnaire 9-item and Generalized Anxiety Disorder 7-item measures were used to weigh depression and anxiety scores across the Life Events Checklist for the DSM-5 (LEC-5) trauma types in a sample (N = 170) of predominantly women of color. We examined three respondent groups based on proximity and frequency of PTEs: (1) denied; (2) witnessed/learned about; and (3) experienced. Results indicate that those experiencing higher levels of PTEs (namely, sexual assault, unwanted/uncomfortable sexual experience, and sudden accidental death) also experienced higher ratings of depression and anxiety. More research is indicated, as women of color within ABE settings could benefit from tailored resources for prevention, intervention, and treatment.

The purpose of this research is to investigate community well-being among historically marginalized communities within a shared city setting, with implications for programmatic changes within city government. The Social Cognitive Theory framework and seminal and emergent public health literature were used to develop 10 open-ended questions that assessed community mental, physical, emotional, and spiritual health and well-being. Six virtual focus groups (N = 41) were conducted between June 2020 and November 2021. Participants represented the artist activist, Asian American, Reentry, LGBTQIA+, youth leadership, and faith-based communities. Qualitative analyses observed four meta themes: (community; barriers; access, city government) and 32 subthemes themes (including: action and change; social isolation or connection; family; art; environment; well-being; culture, race, ethnicity; education; mental health; racism, stigma, marginalization; and economic stability and food security). Resources that are specialized, culturally congruent, contextualized, and integrated to promote underserved groups were identified as optimal for community well-being and effective city government partnerships.

OBJECTIVES:Tobacco use disproportionately affects Alaska Native people. Physical activity may aid quitting smoking and provides health benefits. We tested telemedicine-delivered heart health interventions in Alaska's Norton Sound region. METHODS:Alaska Native adults (N = 299, 51.5 % male, 60.5 % Inupiaq) with hypertension and/or hypercholesterolemia who smoked daily were randomized to intervention on smoking and physical activity (group 1) or traditional diet and medication adherence (group 2). Intention to change was not required for participation. Stage-tailored mailed workbooks and personalized reports were supported by telehealth counseling at baseline, 3, 6, and 12 months. Study outcomes were assessed at baseline, 3-, 6-, 12-, and 18-months (i.e., 6-months after the final counseling session). Smoking outcomes were self-reported 7-day point prevalence abstinence (7d-PPA),1 bioconfirmed with urine anabasine; 24-hour quit attempts; and 50 % reduction in smoking. Self-reported physical activity outcomes were metabolic equivalent of task (MET) minutes and meeting moderate-to-vigorous physical activity (MVPA) guidelines. RESULTS:At baseline, participants averaged 12.4 (SD = 10.0) cigarettes/day, with 19.4 % prepared to quit smoking, and 81.6 % meeting MVPA guidelines. During the study, most (70.2 % group 1; 63.5 % group 2) reported a 24-hr quit attempt (p = 0.219), and Group 1 (53.6 %) was more likely than Group 2 (28.4 %) to use nicotine replacement therapy (NRT), OR = 2.92, p < 0.001. At 18-months, 40.5 % (group 1) and 32.5 % (group 2) had reduced their smoking by half or more (p = 0.343), and 10.8 % vs. 7.9 % (group 1 vs. 2) reported 7d-PPA with 4 % vs. 6 % (group 1 vs. 2) bioconfirmed. Time and baseline stage of change predicted 7d-PPA (p's≤.015), with no group effect (p = 0.325). Activity levels did not significantly differ by group or time. CONCLUSIONS:Telemedicine counseling supported NRT use but did not significantly affect behavioral outcomes.

Many individuals recover from alcohol problems without formal treatment (referred to here as self-change). However, self-change is understudied, especially among racially and ethnically minoritized (REM) populations. The present paper is a systematic literature review on self-change from alcohol problems among REM adults in the U.S. Fifteen articles met criteria for inclusion. Of these, the majority (9) described the process of self-change among American Indian and Alaska Native communities and traditional healing strategies (e.g., meeting with elders or traditional healers) were commonly used. Fewer studies described self-change among Black and Latine groups, and no studies provided data on Asian, Native Hawaiian, Pacific Islander, or Multiracial groups. Self-change among REM groups has been studied most often among American Indian and Alaska Native groups. Additional research is needed to better understand self-change among REM groups, including the influence of relevant constructs like racial identity.

Social and systemic barriers contribute to students’ attrition from K-12 education and enrollment in adult basic education (ABE) via the reduction of available resources. Informed by Conservation of Resources Theory, the current study assessed the impact of stress-related risk factors, including trauma and COVID-19-related stress, on ABE students’ ( N = 227) vocational confidence. Understanding these factors can inform ABE program development and retention efforts. Survey methods with convenience sampling were used for data collection. Structural equation modeling was used to examine the relationship between trauma exposure and COVID-19-related stress on the outcomes of alcohol use, as a stress response, as well as vocational confidence. On average, past traumatic experiences were more common among ABE students who reported greater social or economic marginalization, especially those identifying as lesbian, gay, or bisexual or with a history of being unhoused. More past traumatic experiences predicted higher COVID-19-related stress and alcohol use. Higher COVID-19-related stress, in turn, predicted lower vocational confidence. ABE students experiencing marginalization face compounded barriers to achieving their educational and vocational goals when they experience trauma exposure and subsequent stressors. Based on findings, we make practice recommendations for ABE centers, including targeted psychoeducational resources to offset social and systemic stressors that may bolster the vocational confidence of enrolled students.

Adult basic education (ABE) programs in the United States serve millions of students annually to help them achieve high school equivalency, English proficiency, and other skills. These skills are necessary for upward mobility and competitiveness in the labor market, which is important for ABE students who are disproportionately affected by racial/ethnic disparities and poverty. Among learners who are not in ABE programs, substance use and trauma affect student outcomes. Similar research is limited among ABE students. Understanding the influence of these factors among ABE students can better inform interventions. The current study, grounded in Stress and Coping Theory, examined rates, risk factors, and gender differences for substance use and trauma among 286 ABE students. Results indicated that trauma is prevalent and associated with substance use, substance use suggests a need for brief counseling, and there were gender differences in substance use behaviors. Recommendations for interventions among ABE programs are discussed.

My mother was beautiful. Once, I remember driving down the Glenn Highway from Wasilla to Anchorage, Alaska, and a man nearly ran us off the road. He was making eyes at my mother so fiercely that his wheel, just like his intensions, veered towards us trying desperately to collide with her in any way possible. In hindsight, I too lived just outside of reaching my mother, earnestly yearning for her to turn and see me.

Background:American Indian and Alaska Native (AI/AN) peoples are disproportionately impacted by substance use disorders (SUDs) and health consequences in contrast to all racial/ethnic groups in the United States. This is alarming that AI/AN peoples experience significant health disparities and disease burden that are exacerbated by settler-colonial traumas expressed through prejudice, stigma, discrimination, and systemic and structural inequities. One such compounding disease for AI/AN peoples that is expected to increase but little is known is Alzheimer's disease and related dementias (ADRD). AI/AN approaches for understanding and treating disease have long been rooted in culture, context, and worldview. Thus, culturally based prevention, service, and caregiving are critical to optimal outcomes, and investigating cultural beliefs regarding ADRD can provide insights into linkages of chronic stressors, disease, prevention and treatment, and the role of substance misuse.Method:To understand the cultural practices and values that compose AI/AN Elder beliefs and perceptions of ADRD, a grounded theory, qualitative study was conducted. Twelve semistructured interviews with AI/AN Elders (M age = 73; female = 8, male = 4) assessed the etiology, course, treatment, caregiving, and the culturally derived meanings of ADRD, which provides a frame of understanding social determinants of health (SDH; eg, healthcare equity, community context) and impacts (eg, historical trauma, substance misuse) across the lifespan.Results:Qualitative analyses specific to disease etiology, barriers to treatment, and SDH revealed 6 interrelated and nested subthemes elucidating both the resilience and the chronic stressors and barriers faced by AI/AN peoples that directly impact prevention, disease progression, and related services: (1) postcolonial distress; (2) substance misuse; (3) distrust of Western medicine; (4) structural inequities; (5) walking in two worlds; and (6) decolonizing and indigenizing medicine.Conclusion:Barriers to optimal wellbeing and SDH for AI/AN peoples are understood through SUDs, ADRD, and compounding symptoms upheld by colonial traumas and postcolonial distress. En masse historical and contemporary discrimination and stress, particularly within Western medicine, both contextualizes the present and points to the ways in which the strengths, wisdom, and balance inherent in AI/AN culture are imperative to the holistic health and healing of AI/AN peoples, families, and communities.

Alaska Native (AN) peoples have resided in rural, collectivist systems for time immemorial. However, AN history has been punctuated by manifold and often generational changes to these systems. Family structures, expressions of culture, land-based identities, and AN cosmology and ontology have been directly impinged upon by colonisation. Evidence of this exists in outward migration, climate change, health disparities and Western systems of health, learning and knowledge. Resilience, successful ageing, and quality of life are evident in community resources, inward migration, and the cultural and contextual factors that compose tribal group identity. All are firmly grounded within place, community strengths, and cultural revitalisation, and are embedded in land and nature. A sample of adults within rural Alaska were recruited to share their collective and lived realities related to their quality of life. Focus groups consisted of interactive tasks and thematic analyses. Nine salient themes were revealed: family; subsistence; access to resources; health and happiness; traditional knowledge and values; acts of self; providing; sobriety; and healing. All emphasised the cyclical and grounded nature of collective resilience and reclamation of Indigenous ways. Further, research demonstrates how AN Elder knowledge, intergenerational connection and generativity, and indigenised tenets of successful ageing are how rural AN communities become well, stay well, and pass on healing and wellness to future generations. Indigenous ageing provides a lens to understand AN quality of life and the symbiosis of rurality. An analysis of the historical changes to the AN cultural system, successful ageing, and an Indigenous, holistic framework of AN quality of life will be provided.

Introduction: Evidence suggests that psychedelics may serve as a therapeutic approach to reduce substance use; however, people with racial and ethnic minoritized (REM) identities are often excluded from this research. We investigated whether psychedelic use affects other substance use among REM people and whether perceived changes in psychological flexibility and racial trauma mediates this association.Methods: REM people in the United States and Canada (N = 211; 32 % Black, 29 % Asian, 18 % American Indian/ Indigenous Canadian, 21 % Native Hawaiian/Pacific Islander; 57 % female; mean age = 33.1, SD = 11.2) completed an online survey retrospectively reporting their substance use, psychological flexibility, and racial trauma symptoms 30 days before and after their most memorable psychedelic experience.Results: Analyses showed a significant perceived reduction in alcohol (p < .0001, d = 0.54) and drug use (p = .0001, d = 0.23) from before to after the psychedelic experience. Preliminary associations found perceived re-ductions in racial trauma symptoms were associated with perceived reductions in alcohol use and this association varied by race, dose, ethnic identity, and change in depressive symptoms. Specifically, Indigenous participants experienced greater perceived reductions in alcohol use relative to participants who identified as Asian, Black, or other. Those who took a high dose of psychedelics experienced greater perceived reductions in alcohol use relative to those who took a low dose. Participants with a stronger ethnic identity and those with a perceived reduction in depressive symptoms experienced a perceived reduction in alcohol use. Serial mediation indicated a perceived increase in psychological flexibility and reduction in racial trauma symptoms mediated the association between acute psychedelic effects and perceived reductions in alcohol and drug use.Conclusion: These findings suggest that psychedelic experiences may contribute to an increase in psychological flexibility and reduction in racial trauma symptoms and alcohol and drug use among REM people. REM people have been largely excluded from psychedelic treatment research even though psychedelic use is considered a traditional healing practice in many communities of color. Longitudinal studies of REM people should replicate our findings.

Introduction: American Indian and Alaska Native (AI/AN) populations are disproportionately affected by substance use disorders (SUDs) and related health disparities in contrast to other ethnoracial groups in the United States. Over the past 20 years, substantial resources have been allocated to the National Institute on Drug Abuse Clinical Trials Network (CTN) to disseminate and implement effective SUD treatments in communities. However, we know little about how these resources have benefitted AI/AN peoples with SUD who arguably experience the greatest burden of SUDs. This review aims to determine lessons learned about AI/AN substance use and treatment outcomes in the CTN and the role of racism and Tribal identity. Method: We conducted a scoping review informed by the Joanna Briggs framework and PRISMA Extension for Scoping Reviews checklist and explanation. The study team conducted the search strategy within the CTN Dissemination Library and nine additional databases for articles published between 2000 and 2021. The review included studies if they reported results for AI/AN participants. Two reviewers determined study eligibility. Results: A systematic search yielded 13 empirical articles and six conceptual articles. Themes from the 13 empirical articles included: (1) Tribal Identity: Race, Culture, and Discrimination; (2) Treatment Engagement: Access and Retention; (3) Comorbid Conditions; (4) HIV/Risky Sexual Behaviors; and (5) Dissemination. The most salient theme was Tribal Identity: Race, Culture, and Discrimination, which was present in all articles that included a primary AI/AN sample (k = 8). Themes assessed but not identified for AI/AN peoples were Harm Reduction, Measurement Equivalence, Pharmacotherapy, and Substance Use Outcomes. The conceptual contributions used AI/AN CTN studies as exemplars of community-based and Tribal participatory research (CBPR/ TPR). Conclusion: CTN studies conducted with AI/AN communities demonstrate culturally congruent methods, including CBPR/TPR strategies; consideration/assessment of cultural identity, racism, and discrimination; and CBPR/TPR informed dissemination plans. Although important efforts are underway to increase AI/AN participation in the CTN, future research would benefit from strategies to increase participation of this population. Such strategies include reporting AI/AN subgroup data; addressing issues of cultural identity and experiences of racism; and adopting an overall effort for research aimed at understanding barriers to treatment access, engagement, utilization, retention, and outcomes for both treatment and research disparities for AI/AN populations.

Abstract The Alaska Native (AN) life cycle is circular and fluid, with each aspect explaining and informing the process of aging within one’s context and understood through concepts of quality of life, successful aging, and life span development. This is particularly critical given the changing social, familial, and cultural structures of the AN context, beginning at colonization and persisting to the present. Holistic, strengths-based, and indigenized approaches to aging and caregiving are imperative to unraveling the systemic, community, and group stigma and marginalization, while simultaneously underscoring the resilience and power of AN cultural models of aging well. This chapter discusses research findings based on a grounded theory approach that was used to understand AN Elder perceptions of memory and views on aging through a wisdom-based, cultural framework. A purposive sample of 12 Alaska Native Elders were interviewed, and qualitative analyses revealed eight overarching and interconnected themes. These themes are inextricably linked to cultural group identity, collectivism, and a spiritualized view of eldership embedded in the AN life cycle. Conceivably, life span developmental theories may provide foundational tenets for the AN life cycle, thus providing a framework to enhance and expand an explanatory and culturally based theoretical framework for understanding aging as a process from birth to the grave and beyond.

Abstract Systemic barriers contribute to attrition from K-12 education contexts and later involvement in adult education centers, especially among students from minoritized backgrounds. To assess the impact of stress-related risk factors, including trauma exposure and COVID-19-related stress, on ABE students and their barriers to academic and vocational success. Survey methods were used for data collection, and analysis of variance and structural equation modeling were used to test hypotheses. Results showed that past traumatic experiences were more common among ABE students who reported greater social or economic marginalization, especially those identifying as lesbian, gay, or bisexual or with a history of being unhoused. We observed that more traumatic experiences predicted higher COVID-19-related stress and alcohol misuse. Higher COVID-19-related stress, in turn, predicted lower job confidence. ABE students experiencing marginalization face compounded barriers to educational and vocational goals with trauma exposure and COVID-19-related stress. Based on findings, practice recommendations for ABE centers include targeted psychoeducational resources to offset systemic stressors and bolster academic and vocational attainment, such as on-site service delivery and using ABE centers as service system access points.

Introduction. Innovations are needed for preventing cardiovascular disease (CVD) and for reaching diverse communities in remote regions. The current study reports on a telemedicine-delivered intervention promoting a traditional heart-healthy diet and medication adherence with Alaska Native men and women residing in the Norton Sound region of Alaska. Methods. Participants were 299 men and women with high blood pressure or high cholesterol smoking daily who were randomized to receive telemedicine-delivered counseling and printed materials on diet and medication adherence or on smoking and physical activity. Intervention contacts were at baseline and 3-, 6-, and 12-months follow-up, with a final assessment at 18 months. Nutrition outcomes were the ratio of heart-healthy foods and traditional heart-healthy foods relative to all foods reported on a 34-item food frequency questionnaire. Recent and typical adherence for heart medications were self-reported. Results. Intervention effects were significant for the heart-healthy foods ratio at 6 months only (p = 0.014) and significant for the traditional heart-healthy foods ratio at 6 months only for those aged 47+ (p = 0.031). For recent and typical medication adherence, there were no significant group differences by time. Discussion. In a remote region of Alaska, telemedicine proved feasible and acceptable for engaging Alaska Native men and women in counseling on CVD risk behaviors. The findings indicate that more touchpoints may be necessary to impart comprehensive lasting change in heart-healthy eating patterns. Medication adherence group differences were not significant; however, medication adherence was high overall.

Indigenous research posits that practice-based evidence is fundamental to culturally grounded, multifaceted methods. The objective is to outline the key tenets and characteristics of Elder-centered research and relevant methodology using an interconnected progression of Alaska Native studies. Semi-structured interviews were conducted with 12 Alaska Native Elders, 21 Alaska Native caregivers, and 12 Alaska Native and non-Native caregivers in two studies exploring cultural understandings of memory and successful aging. The design and implementation of these studies employed Elders at every level, ensuring cultural relevance, outcomes, and dissemination. Results reflect the benefits of engaging Alaska Native Elders in research and reveal methods for best practices: (a) creating advisory councils, (b) identifying stakeholders, (c) weaving together Elder and western knowledge systems, and (d) the reciprocal nature of Elder engagement and well-being. This research centers Indigenous values and research for an Elder-centered methodology that encourages engagement of older adults in applicable, meaningful, restorative, and enculturated ways.

Abstract Alaska Native (AN) people’s incidence and prevalence of Alzheimer’s Disease and Related Dementias (ADRD) are projected to disproportionately increase in contrast to the U.S. population. This is alarming given that AN peoples experience health disparities exacerbated by prejudice, stigma, and systemic and structural inequalities. Twelve semi-structured interviews with AN Elders assessed the culturally derived meanings of memory function, loss, decline, and disease. Qualitative analyses observed eight culturally grounded themes and five interrelated and nested subthemes elucidating both the resilience and the stigmas, racism, and barriers faced by AN peoples: (1) Historical Trauma; (2) Oppression; (3) Distrust of Western Medicine; (4) Social Justice; and (5) Walking in Two Worlds. En masse historical and contemporary oppression, particularly within Western medicine, both contextualizes the present and points to the ways in which the strengths, wisdoms, and balance inherent in AN culture are imperative to the holistic health and healing.

Background Existing epidemiological data suggest differences across racial/ethnic groups in drug and alcohol treatment utilization and barriers to treatment and typically include only Black, Latine, and White adults. The objective of this study was to examine whether disparities remain for DSM-5 lifetime alcohol use disorder (AUD) and drug use disorder (DUD) treatment utilization and barriers across Black, American Indian/Alaska Native (AI/AN), Latine, Asian/Pacific Islander/Native Hawaiian (Asian/PI/NH), and White adults. Methods The current study conducted secondary analyses on data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC-III). Regression analyses, followed by pairwise comparisons, investigated differences across racial/ethnic groups. Results Analyses indicated differences across racial/ethnic groups in AUD treatment utilization. White and AI/AN adults were more likely to utilize a health care professional than were Black adults. Asian/PI/NH and Latine adults were more likely to endorse language as a barrier to AUD treatment than were White adults. Black adults were more likely to use 12-step programs for DUD treatment utilization than were White and Latine adults, and Black and White adults were more likely to use outpatient programs than were Latine adults. Further, Black adults were more likely than Asian/PI/NH and Latine adults to use specialty DUD treatment. AI/AN, Asian/PI/NH, and White adults were more likely to endorse fear of what others would think as a barrier to DUD treatment relative to Black adults. AI/AN adults were more likely to endorse fear of being hospitalized relative to Black, Latine, and White adults. Asian/PI/NH and Latine adults were more likely to indicate that the hours were inconvenient relative to Black and White adults. White adults were more likely to endorse a family member objected relative to Black adults. AI/AN and White adults were more likely to endorse they stopped on their own relative to Black, Asian/PI/NH, and Latine adults. Further, AI/AN and White adults reported the greatest number of barriers to DUD treatment. Conclusions Differences remain across racial/ethnic group in drug and alcohol treatment utilization and barriers to treatment. Future research aimed at increasing treatment utilization across racial/ethnic groups should focus on social determinants of health.

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Abstract Alaska Native (AN) Elders have historically been underrepresented in research. Innovative AN research posits that practice-based evidence is fundamental to culturally grounded, multifaceted methods. AN Elders is a cultural convention distinguishing Elders who continue to serve as an integral part of their family and community and recognized by their community as role models. Several studies will be discussed which employed Elders at every level of the research, ensuring cultural relevancy, outcomes, and dissemination activities. The findings lay the foundation for an Elder-centered research methodology that can be adapted and applied in other studies to encourage engagement of older adults. This methodology has potential to impact research for underrepresented groups and to rethink and reshape Western-centric practices. Findings from this research provides best practices for capacity building and sustainability, strategies for empowerment and prevention, and a framework for supporting the AN community in all phases of research.

The perspectives of Alaska Native (AN) peoples are rarely represented in quality of life (QOL) research. AN representation and voice is imperative to mitigating health disparities and in health promotion for AN peoples. To address these gaps, a sample of 15 AN people (six male, nine female) was recruited to participate in stakeholder QOL research. Five focus groups participated in activities that led participants to identify 28 themes; qualitative data analyses led researchers to identify seven additional themes. All 35 themes were integrated and reduced to the following nine culturally-grounded QOL themes: family, subsistence, access to resources, health and happiness, traditional knowledge and values, acts of self, providing, sobriety, and healing. These themes reflect the values of the participants and are exemplars of a culturally relevant, community based participatory research approach. Future research and health service implications - such as future development of a measure of AN QOL to improve wellness in healthcare settings and beyond - are discussed.