Development of a New Substance Prevention Program Using Culture for Urban Native American Youth

American Indian/Alaska Native (AI/AN) youth demonstrate high substance use rates. However, evidenced-based, culturally-tailored prevention programs targeting urban AI/AN youth, where approximately 70% of AI/ANs reside, are limited.

Motivational Interviewing and Culture for Urban Native American Indian Youth (MICUNAY) is an integrated approach utilizing both MI and AI/AN traditional based healing activities. This project will intervene at the individual and community level in order increase feasibility and sustainability. Youth will receive MICUNAY, a three session program. Each session will combine one hour of group MI focused on alcohol and other drug (AOD) use, and one hour focused on an AI/AN traditional based healing activity.  Community Wellness Gatherings (CWGs) every other month will address AOD use and prevention.

Methods:  We conducted ten focus groups at 2 clinical sites in southern and northern California among AI/AN youth ages 14-18, parents of AI/AN, providers, and 2 MICUNAY Community Advisory Boards (CABs). We obtained feedback on AOD use and trends among urban AI/AN youth, AOD risk factors, cultural identity issues and their relation to AOD use, and on the MI content and choices of cultural activities utilized (i.e., AI/AN drumming, regalia making) for each MICUNAY session.

Results: Themes that emerged regarding AOD use were: focus on how to make a healthy choice given the risk factors, how AOD use affects the body physically, mentally, and spiritually, and consequences of AOD use. Some traditional activities that the groups said would “fit” with these AOD discussions included prayer, learning about one’s culture and tribe, smudging, basket weaving, beading, and cooking. While many youth wanted to learn about their tribal history and culture, some urban youth did not feel their AI/AN identity was relevant. Respondents also described the importance of developing a “pan-Indian” identity while empowering youth to learn about their own Tribe-specific roots.

Conclusions: Involving the AI/AN community in program development is crucial to the success of MICUNAY. The groups emphasized the importance of ensuring that MICUNAY is culturally relevant for teens. The issues highlighted in the groups indicated that addressing AOD use in this population is essential given the challenges that AI/AN youth in these urban communities face. In addition, the groups stressed the importance of providing cultural activities that would resonate for all youth regardless of their tribe.