A Third-Generation Family-Centered Alcohol and Drug Prevention Program for Indigenous Families and Children

Introduction: The first Indigenous adaptation of the Strengthening Families Program (Guyll, et al., 2004; Redmond, Shin, Eickhoff, & Spoth, 2003; Spoth, et al., 2008), the Bii-Zin-Da-De-Dah (BZDDD: Listening to One Another) program is a culturally specific, family intervention designed to reduce alcohol and other drug use among American Indian early adolescents. The original program (1996-2001), supported by The National Institute on Drug Abuse (DA10049), focused on 5th – 8th grade Ojibwe adolescents and their families. Trial results indicated that the program was effective only for younger adolescents who had not begun experimenting with substances. Subsequent revisions to the program were made to make it appropriate for 3rd and 4th grade students. For example, the number of sessions was increased to 14 and more cultural content was added.

The second generation BZDDD has been adapted for use by Dakota, Navajo, Pueblo, and Dakota cultures. Part of the intervention trials being implemented in these four communities is to understand if the program adaptations strengthen the intervention impacts and how the contexts of these four communities will require that the intervention to be adapted in different ways.

Methods: Data from focus groups were used to refine and adapt the 2nd generation program to include additional lessons related to mental health promotion. We then piloted the intervention on four Ojibwe First Nations.  We tracked attendance/graduation conducted brief weekly feedback sessions and 3 month post-program focus groups with parents and children.

Results:  The adaptation has resulted in high levels of community ownership, family attendance, and graduation rates.  Our graduation rates for the 2nd generation program with 14 sessions are higher than those of the original 5-session Strengthening Families Program. In addition, family satisfaction is very high with families asking to repeat the intervention. In one community, the program graduation ceremony was adopted at the reserve high school graduation and a program song performed for community elders.  Although we have not yet analyzed effects on the targeted intervention outcomes, the program has been extremely popular.

Conclusions: Our community and culturally based approach has been extremely successful in developing ownership and participation despite increasing the number of program sessions when tailoring the program. We will discuss how what we have learned in piloting this intervention in these four indigenous communities can inform other interventions being tailored and adapted to different contexts.