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This study aimed to: characterize the reasons why Indigenous youth abstain from alcohol; explore how these reasons vary by age, sex, and whether or not the youth reside on or off a reservation; and examine how reasons for abstaining may mediate the relationship between cultural identity and intentions to drink 5\u2009years in the future.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Data were sourced from the Substance Use Among American Indian Youth: Epidemiology and Etiology, [United States], 2015\u20132020 study. Data from 2665 Indigenous youth (48.1% female,\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      \u2009=\u200914.2 (SD\u2009=\u20091.7)) who reported no lifetime alcohol use were extracted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Factor analysis of the reasons for abstaining from alcohol resulted in two factors: to avoid negative consequences and due to social reasons. Females (vs. males), younger (vs. older) youth, and youth who lived on a reservation (vs. those who did not) endorsed avoiding consequences and social reasons as more important (\n                      <jats:italic>p<\/jats:italic>\n                      's\u2009&lt;\u20090.01). A serial mediation analysis found that, while controlling for age, sex, and reservation\u2010dwelling, social, but not negative consequences, reasons significantly mediated the relationship between cultural identity and intention to drink 5\u2009years in the future (indirect effect\u2009=\u2009\u22120.020,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02, 95% CI [\u22120.039, \u22120.005]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results extend previous research on the protective role of cultural identity on alcohol use and suggest that developing social reasons to abstain from alcohol may be a modifiable risk factor to encourage alcohol abstinence in Indigenous youth.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70253","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T07:06:01Z","timestamp":1775718361000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with alcohol abstinence in North American Indigenous youth: Age, gender, and cultural identity"],"prefix":"10.1111","volume":"50","author":[{"given":"Lindsey","family":"Fisher\u2010Fox","sequence":"first","affiliation":[{"name":"Department of Psychology Indiana University\u2014Indianapolis  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Locklear","sequence":"additional","affiliation":[{"name":"Department of Psychology Arizona State University  Tempe Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Girard","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Rhode Island  Kingston Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1990-8337","authenticated-orcid":false,"given":"Melissa A.","family":"Cyders","sequence":"additional","affiliation":[{"name":"Department of Psychology Indiana University\u2014Indianapolis  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1898-2263","authenticated-orcid":false,"given":"Meghan","family":"Crabtree","sequence":"additional","affiliation":[{"name":"Tri\u2010Ethnic Center for Prevention Research Colorado State University  Fort Collins Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nichea S.","family":"Spillane","sequence":"additional","affiliation":[{"name":"Department of Psychology Arizona State University  Tempe Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,9]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826084.2011.592432"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826089709035617"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/10826089909029389"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2011.628913"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-022-01373-5"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11121\u2010016\u20100680\u20101"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022146510393973"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.923464"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1037\/abn0000817"},{"key":"e_1_2_8_11_1","first-page":"367","article-title":"The need for local communities' involvement in the future of real cultural heritage","volume":"2","author":"\u0106wik A.","year":"2020","journal-title":"Kultura\u2010Spo\u0142ecze\u0144stwo\u2010Edukacja"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272431611414062"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adolescence.2020.07.006"},{"key":"e_1_2_8_14_1","unstructured":"Fisher\u2010Fox L. 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