Session: Prevention Trial in the Cherokee Nation: Effects of Community Environmental Change and School-Based Brief Interventions on Alcohol Use Among Adolescents (Society for Prevention Research 24th Annual Meeting)

Despite advances in prevention science and practice in recent decades, the U.S. continues to struggle with significant alcohol-related risks and consequences among youth, especially among vulnerable rural and American Indian youth. The Prevention Trial in the Cherokee Nation is a partnership between prevention scientists and Cherokee Nation Behavioral Health to create, implement, and evaluate an integrated community-level intervention designed to prevent underage drinking and associated negative consequences among American Indian and other youth living in rural high-risk underserved communities. Six key research design elements optimize causal inference and experimental evaluation of intervention effects, including purposive selection of towns, random assignment to study condition, an intensive longitudinal design, nested cohorts as well as repeated cross-sectional observations, a factorial design crossing two conceptually distinct interventions, and multiple comparison groups. The study involved six rural communities and their high school populations located within the 14-county tribal jurisdictional service area of the Cherokee Nation. In this symposium we describe the overall study design and population, details of the implementation of the two interventions, and results from the main outcome analysis on 30-day alcohol use. Implementation strategies and results presented will inform prevention development and planning for rural communities that are home to culturally diverse and high-risk populations.