Building a Culturally Grounded Substance Use Prevention Program for American Indian Youth and Families: Integrating Scientific Evidence and Cultural Knowledge

Introduction:  It is well documented that problematic substance use is widespread in many American Indian communities.  It is equally clear that early adolescence is a critical period for the development of subsequent substance problems.  Prevention science has made great strides in identifying and documenting effective strategies for delaying the initiation of substance use in a variety of populations across the United States, but there is still no clear evidence base around effective strategies for American Indian youth.  Bridging the gap between prevention science and Native communities will require a strong commitment to scientific rigor and an equally strong commitment to the integrity of American Indian cultures and the local practices that sustain cultural values. 

Methods:  Researchers are partnering with a Northern Plains reservation community where rates of substance problems are particularly high.  We are working together to adapt, implement, and rigorously evaluate an early substance use prevention program. The identification of early substance use as a target, the need to support parenting, and the importance of involving extended families emerged in the context of a longstanding university-tribal community relationship.  Together, researchers, cultural experts, and community members working with youth selected an evidence-based practice (the Iowa Strengthening Families Program- ISFP) with the goal of anchoring it within cultural practice arising from within the community.  A key goal of this process is to ensure fidelity to the core components of ISFP while delivering the program in a manner that will resonate with youth and families in the local reservation culture, building on cultural strengths to connect with and reinforce ISFP. 

The Field Team, consisting of a seasoned community researcher and a doctoral-level clinical psychologist, both enrolled members of the tribe and members of the reservation community, are leading the adaptation the ISFP, while working with cultural advisors, the scientific team, and those who developed the original intervention. The team is also soliciting broader input through targeted surveys and focus group discussions with parents, youth, and others in the community (particularly elders).  We are using an iterative process, beginning with training the team (including community advisors) in the ISFP curriculum, proposing changes session-by-session, scientific and cultural review of the adapted curriculum (by the CU team and community advisors, respectfully), then proposing additional changes. This process is being repeated for each session until we have consensus that the final session plans have both scientific integrity and cultural validity.

 

Results:  We will describe the adaptation process and the final culturally-grounded program created through that process.  We will highlight key changes to the ISFP program and key elements of the 7D teachings that have been incorporated, linking each to the balance of scientific evidence and cultural protocols.  We will also discuss the implementation of this program with youth and families on the reservation and the evaluation of its effectiveness for delaying initiation and reducing levels of substance use among youth.