Session: Adapting and Testing Interventions in American Indian Communities: Lessons Learned (Society for Prevention Research 24th Annual Meeting)

Health disparities in indigenous U.S. communities are well-documented and substantial, including disparities in life expectancy, morbidity, chronic disease risk factors and quality of life. American Indian (AI) adolescents report the highest levels of substance use compared to non-AI youth; the suicide rate for AI/AN/NH adolescents and young adults is two and half times higher than the national average; and AI/AN/NH individuals born today have a life expectancy that is 4.2 years less than other U.S. groups. Recognizing the need for intervention research in this population, NIH issued program announcement PAR-11-346 Interventions for Health Promotion and Disease Prevention in Native American Populations. This session discusses two funded projects, focusing on challenges encountered and lessons learned, cultural infusion, and suggestions for best practices.

Paper #1 discusses the adaptation and testing of an anti-drug and alcohol communications campaign – Be Under Your Own Influence (BUYOI) – among 7^th graders on or near AI reservations. BUYOI has been effective in reducing uptake of marijuana and alcohol among youth in multi-ethnic communities, but has not been adapted and tested for AI youth. Adaptation posed fewer challenges than building the foundation from which to work, resolving institutional conflicts, and keeping the project moving forward. The authors discuss lessons learned and recommendations for working in AI reservation communities, including allowing for significant face-to-face time and relationship building.

Papers #2 and #3 discuss adaptation of the Iowa Strengthening Families Program for Parents and Youth 10-14 (SFP 10-14), as part of the project “Culturally grounded substance use prevention for American Indian families”. Researchers embarked on a collaborative review of the SFP 10-14 curriculum, with careful attention to fidelity to community partners’ suggestions, as well as to core components of the program. The adapted program, Thiwáhe Gluwáš’akapi (“sacred home in which families are made strong”) was piloted in Spring, 2015 and is now being implemented and evaluated for effectiveness. Presentation #2 highlights the processes used to ensure cultural integrity, steps taken to retain core components of SFP 10-14, challenges in the adaptation process, and approaches to balancing program fidelity with cultural/community fit. Difficulties in creating a cultural foundation in an already established program are discussed. Presentation #3 addresses a specific piece of this adaptation, modifying the videos by grounding them in local culture while retaining core messages. Examples are shared, documenting the reasons for changes and demonstrating how cultural context was accommodated while retaining fidelity to the core components.