title: Mapping the social determinants of substance use for pregnant-involved young Aboriginal women.
abstract: There is a dearth of knowledge about the social determinants of substance use among young pregnant-involved Indigenous women in Canada from their perspectives. As part of life history interviews, 17 young pregnant-involved Indigenous women with experiences with substances completed a participant-generated mapping activity CIRCLES (Charting Intersectional Relationships in the Context of Life Experiences with Substances). As women created their maps, they discussed how different social determinants impacted their experiences with pregnancy and substance use. The social determinants identified and used by women to explain determinants of their substance use were grouped into 10 themes: traumatic life histories; socioeconomic status; culture, identity and spirituality; shame and guilt; mental wellness; family connections; romantic and platonic relationships; strength and hope; mothering; and the intersections of determinants. We conclude that understanding the context and social determinants of substance use from a woman-informed perspective is paramount to informing effective and appropriate programs to support young Indigenous women who use substances.
authors.affiliation: a Faculty of Health and Social Development , University of British Columbia , Kelowna , Canada.
authors.forename: Sana Z
authors.initials: SZ
authors.lastname: Shahram
authors.affiliation: b Institute for Healthy Living and Chronic Disease Prevention, and School of Nursing, Faculty of Health and Social Development , University of British Columbia , Kelowna , Canada.|c Faculty of Health Sciences , Australian Catholic University , Melbourne , Australia.
authors.forename: Joan L
authors.initials: JL
authors.lastname: Bottorff
authors.affiliation: d School of Nursing, Faculty of Health and Social Development , University of British Columbia , Kelowna , Canada.
authors.forename: Nelly D
authors.initials: ND
authors.lastname: Oelke
authors.affiliation: d School of Nursing, Faculty of Health and Social Development , University of British Columbia , Kelowna , Canada.
authors.forename: Donna L M
authors.initials: DL
authors.lastname: Kurtz
authors.affiliation: e Wuikinuxv Nation , The Cedar Project , Vancouver , Canada.
authors.forename: Victoria
authors.initials: V
authors.lastname: Thomas
authors.affiliation: f School of Population and Public Health , University of British Columbia , Vancouver , Canada.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Spittal
authors.lastname: And For The Cedar Project Partnership
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D003469:Culture; D005260:Female; D006167:Guilt; D006801:Humans; D007198:Indians, North American / Q000523:psychology; D008603:Mental Health; D011247:Pregnancy; D011248:Pregnancy Complications; D000067073:Psychological Trauma; D055500:Resilience, Psychological; D012752:Shame; D012923:Social Class; D064890:Social Determinants of Health; D012931:Social Environment; D012944:Social Support; D029181:Spirituality; D019966:Substance-Related Disorders / Q000150:complications*; D055815:Young Adult