# Community Based System Dynamics Models of Alcohol and Substance Exposed Pregnancy in Northern Plains American Indian Women

> **NIH NIH R01** · AVERA MCKENNAN · 2020 · $375,789

## Abstract

PROJECT SUMMARY
Continued trends of alcohol and substance exposed pregnancy (ASEP) indicate a great need for higher quality
ASEP-reduction programs, particularly those that address ASEP health disparities within at-risk populations
and communities, such as American Indian (AI) women. These programs do not account for the broad
constellation of factors pertinent to ASEP, in particular, the role of intimate partner violence (IPV), which forms
a syndemic association with two other ASEP indicators (alcohol and substance use and unplanned
pregnancy). System dynamics methods are effective strategies for understanding of how ASEP and this
syndemic are nested within a broader system of interpersonal, intrapersonal, and institutional factors. This
method is especially beneficial for addressing the current ASEP-related health disparities within AI
communities. Community-based system dynamic models allow practitioners and policymakers to determine the
best system areas for implementing policies and programs that will produce the biggest changes in ASEP. The
current proposal uses community-based approaches to develop ASEP system models for AI women within two
communities: a small metro and a neighboring reservation. These models allow for a researcher-community
partnership to discover important system leverage points for ASEP intervention (reducing ASEP within
pregnant women) and ASEP prevention (focusing on the cyclic relationship between IPV and alcohol and
substance use). The goals of this project are to build and simulate system dynamic models that that represent
the ASEP system in partnership with our highly collaborative community-researcher team. We will calibrate
and validate these models utilizing a variety of community data sources, and then distinguish the most effective
areas to target for reducing ASEP and ASEP predictors that a) generalize across communities and substance
legality, and b) may be uniquely effective within specific communities or for specific substances. This work will
be complemented by individual-level analyses which can estimate the strength of high-priority leverage points
on individual ASEP and ASEP risk. The proposed research is significant as it accounts for the often-ignored
underlying matrix of contributors which maintain community levels of ASEP and ASEP health disparities, and
provides clear recommendations for high-impact methods to reduce ASEP within communities at need. This
project is innovative due to the integration of system simulation and community-based approaches to address
complexity, of this issue, and the integration of descriptive and predictive analyses to provide distinct
empirically-based solutions to address these issues within a translational framework. The strong
interdisciplinary team of researchers with unique, but complementary areas of expertise and the close working
partnership between researchers and the communities of interest are together a powerful collaborative to
facilitate project succes...

## Key facts

- **NIH application ID:** 10271559
- **Project number:** 7R01DA050696-02
- **Recipient organization:** AVERA MCKENNAN
- **Principal Investigator:** Arielle R. Deutsch
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $375,789
- **Award type:** 7
- **Project period:** 2020-10-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10271559

## Citation

> US National Institutes of Health, RePORTER application 10271559, Community Based System Dynamics Models of Alcohol and Substance Exposed Pregnancy in Northern Plains American Indian Women (7R01DA050696-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10271559. Licensed CC0.

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