Creating a Culturally Appropriate Family-Based Substance Use Prevention Program for Use with American Indian Populations: What Does That Mean and How Is It Done?

Introduction:  This paper discusses the process of engaging with an American Indian reservation community to import and culturally adapt an empirically-supported, family-based substance use prevention program (“Culturally grounded substance use prevention for American Indian families”, PAR-11-346 Interventions for Health Promotion and Disease Prevention in Native American Populations). Substance use in this American Indian community starts earlier compared to other communities in the U.S. and the risk for subsequent substance disorder is relatively high. Effective prevention strategies are needed, but there remains a dearth of evidence on effective prevention and intervention strategies for this population. Additionally, evidence with other populations suggests that substance abuse prevention programs designed for specific populations are more effective than one-size-fits-all approaches.  

Methods:  Community partners were engaged to select an evidence-based program for implementation in their community and to participate in the process of grounding the program in American Indian culture and traditions for the selected population.  The research team, guided by these community partners, selected the Iowa Strengthening Families Program for Parents and Youth 10-14 (SFP 10-14) and embarked on a collaborative review process of the SFP 10-14 curriculum. Careful processes were put in place to ensure fidelity to community partners’ suggestions as well as to the core components of the proven SFP 10-14 program, including extensive consultation with the community and SFP 10-14 program staff. The adapted program, Thiwáhe Gluwáš’akapi  (“sacred home in which families are made strong”) was piloted in the Spring of 2015 and is now being implemented and evaluated for effectiveness in the target reservation’s communities. 

Results:  This presentation will highlight the processes used to ensure the cultural integrity of the Thiwáhe Gluwáš’akapi program, steps taken to ensure that core components of SFP 10-14 were retained, challenges in the adaptation process, and specific approaches to balancing program fidelity with cultural and community fit. We will discuss difficulties in defining and creating a cultural foundation in an already established and empirically supported program.  Pilot data will be presented.

Conclusion:  The rigorous process undertaken to translate evidence-based practices to fit within a specific cultural and community context highlights both the challenges and the imperative for this type of work.  The importance of a strong partnership among community members, researchers, and program developers is highlighted, as is the importance of careful attention to both the theoretical foundations of the prevention program and the cultural and community context in which it will be delivered.