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

> **NIH NIH R01** · AVERA MCKENNAN · 2022 · $357,791

## 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 succe...

## Key facts

- **NIH application ID:** 10417209
- **Project number:** 5R01DA050696-04
- **Recipient organization:** AVERA MCKENNAN
- **Principal Investigator:** Arielle R. Deutsch
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $357,791
- **Award type:** 5
- **Project period:** 2020-10-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10417209

## Citation

> US National Institutes of Health, RePORTER application 10417209, Community Based System Dynamics Models of Alcohol and Substance Exposed Pregnancy in Northern Plains American Indian Women (5R01DA050696-04). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10417209. Licensed CC0.

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