PREVENTION OF ALCOHOL MISUSE - A REVIEW OF HEALTH PROMOTION EFFORTS AMONG AMERICAN-INDIANS

Purpose. The purpose of this review is to provide an overview of a wid e range of potentially useful strategies to address the prevention of alcohol misuse among American Indians. This broad approach to the revi ew is useful because the extreme heterogeneity of the American Indian population requires that health promotion professionals explore many o ptions and tailor their activities to specific communities. Search Met hod. A literature search was initiated through MEDLINE using the follo wing key words: prevention, alcohol, substance abuse, American Indian, and Native American. The search yielded 29 articles from the years 19 82 through 1994. These articles, along with 45 previously identified i n three overview articles, form the basis of the review and discussion in this paper. Summary of findings. As a group, American Indians expe rience many health problems that are related to alcohol misuse. Compar ison of Indians to non-Indians shows that the age of first involvement with alcohol is younger, the frequency and amount of drinking is grea ter, and negative consequences are more common. Health promotion progr ams that address these issues must take into account American Indian h eterogeneity and should use a comprehensive approach that addresses bo th heavy drinking and the sequelae of problems related to alcohol misu se. Major Conclusions. Important concepts for providing health promoti on services to this population are: cultural relevance must be careful ly planned and monitored; individuals in the local community must be i nvolved; the drunken Indian stereotype must be addressed; and communit y empowerment should be an important goal.