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Various studies have demonstrated higher alcohol consumption among <jats:styled-content style=\"fixed-case\">AI<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AN<\/jats:styled-content> women during pregnancy compared with other groups. This study intends to understand the milieu within which such consumption patterns flourish. The study utilizes qualitative and quantitative data from the Oglala Sioux Tribe (<jats:styled-content style=\"fixed-case\">OST<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">CHOICES<\/jats:styled-content> Program, a tribally run public health program that aims to reduce alcohol\u2010exposed pregnancy preconceptually in <jats:styled-content style=\"fixed-case\">AI<\/jats:styled-content> women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Alcohol consumption pattern (<jats:italic>n<\/jats:italic>\u00a0=\u00a0264) is analyzed using descriptive statistics. Consumption patterns included average drinks consumed daily, their choice of drinks (beer, whiskey, wine, etc.), how much money participants were spending on alcohol and amount of calories consumed from alcohol. Qualitative data analysis included open coding of data from decisional balance exercise of the <jats:styled-content style=\"fixed-case\">CHOICES<\/jats:styled-content> program that looked at good things and not so good things about participants\u2019 drinking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Women reported drinking an average of 12 drinks daily, ranging between 1 and 86. Women drinking at home spent a median of $4,320 and $12,960 if drinking at a bar. A median of 1,200 calories per day from alcohol was reported. More women reported drinking beer compared with other types of alcohol within a domestic setting. Qualitative data analysis identified positive and negative aspects of drinking among the participants of <jats:styled-content style=\"fixed-case\">OST CHOICES<\/jats:styled-content> Program. Positive aspects included escaping from problems, socializing, and relaxation. Negative aspects included impact on families and domestic violence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>While understanding their milieu, our study also unraveled different struggles (such as violence, peer pressure, financial burden, and depression) encountered by Native women in their daily lives. According to the participants, positive aspects of drinking outweigh the negative aspects and they viewed their drinking as a solution and not a problem.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.13837","type":"journal-article","created":{"date-parts":[[2018,7,4]],"date-time":"2018-07-04T21:04:17Z","timestamp":1530738257000},"page":"1807-1814","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["\u201cBut Problems Dwell so the Urge Is Constant\u2026\u201d Qualitative Data Analysis of the OST CHOICES Program"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5067-5880","authenticated-orcid":false,"given":"Umit","family":"Shrestha","sequence":"first","affiliation":[{"name":"Sanford Research (US, TLW, JDH) Sioux Falls South Dakota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tess L.","family":"Weber","sequence":"additional","affiliation":[{"name":"Sanford Research (US, TLW, JDH) Sioux Falls South Dakota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0824-1920","authenticated-orcid":false,"given":"Jessica D.","family":"Hanson","sequence":"additional","affiliation":[{"name":"Sanford Research (US, TLW, JDH) Sioux Falls South Dakota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,20]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"307","article-title":"Guide for constructing self\u2010efficacy scales","volume":"5","author":"Bandura A","year":"2006","journal-title":"Self\u2010Efficacy Beliefs Adolesc"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.93.10.1683"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2004.07.006"},{"key":"e_1_2_6_5_1","unstructured":"2007 Pearson\/Allyn and Bacon Boston R Bogdan SK Biklen Qualitative Research for Education: An Introduction to Theory and Methods"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/10550490701375251"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2006.00116.x"},{"key":"e_1_2_6_8_1","unstructured":"2009 Substance Abuse and Mental Health Services Administration U.S. Department of Health and Human Services Rockville MD Center for Substance Abuse Treatment What Are Peer Recovery Support Services"},{"key":"e_1_2_6_9_1","first-page":"441","article-title":"Motivational intervention to reduce alcohol\u2010exposed pregnancies\u2013Florida, Texas, and Virginia, 1997\u20102001","volume":"52","author":"Centers for Disease Control and Prevention (CDC)","year":"2003","journal-title":"Morb Mortal Wkly Rep"},{"key":"e_1_2_6_10_1","unstructured":"Centers for Disease Control and Prevention (CDC)(2017)BRFSS prevalence and trends data. 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