Research has indicated that substance use is a significant problem in the American Indian/Alaska Native adolescent community. What is less understood are the risk and protective factors specific to this community. Using data available from the Communities That Care Youth Survey, we analyzed risk and protective factors for current (30-day) and lifetime use of smokeless tobacco, cigarettes, alcohol, marijuana, and alcohol in a sample of 5,912 AI/AN adolescents. Logistic regression analyses were used and our findings indicated that peer and family influences, as well as ease of access to alcohol and other drugs had the greatest overall impact on AI/AN substance use. We also found that religious service attendance was a risk factor for inhalant use, but a protective factor against marijuana use. Overall, our findings highlighted several gaps in the current literature regarding AI/AN cultural attitudes towards substance use and how that might affect teen substance use. It also became clear that the AI/AN community is unique in many ways and would likely benefit from interventions implemented by culturally competent clinicians with the skillset to effectively work with and for the AI/AN community.

LLU Discipline





School of Behavioral Health

First Advisor

Morrell, Holly E. R.

Second Advisor

Hopkins, Gary L.

Third Advisor

Jenkins, Louis E.

Degree Name

Doctor of Psychology (PsyD)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Substance-Related Disorders - Epidemiology - United States; Substance-related Disorders - Ethnology - United States; Social Problems - Ethnology; Indians - North American; Inuits; Mental Health; Alaska Natives - Substance Use; Alaska Natives - Mental Health; Indians of North America - Substance Use; Indians of North America - Mental Health

Subject - Local

American Indians; Substance Abuse; Communities That Care Youth Survey; Cultural Attitudes; Culturally Competent Clinicians


Doctoral Project

Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives

Included in

Psychology Commons