Abstract: Cultural Adaptation of a Contingency Management Intervention for American Indian and Alaska Native Communities (Society for Prevention Research 25th Annual Meeting)

Schedule:

Tuesday, May 30, 2017

Columbia A/B (Hyatt Regency Washington, Washington, DC)

* noted as presenting author

Katherine Hirchak, M.S., Research Assistant, Washington State University, Spokane, WA

Emily Leickly, BA, Research Coordinator, Washington State University, Spokane, WA

Jordan Skalisky, BA, Research Coordinator, Washington State University, Spokane, WA

Jalene Herron, BA, Research Coordinator, Washington State University, Spokane, WA

Jennifer Shaw, PhD, Senior Researcher, Southcentral Foundation, Anchorage, AK

Lisa Dirks, MS, Program Coordinator II, Southcentral Foundation, Anchorage, AK

Jaedon Avey, PhD, Researcher, Southcentral Foundation, Anchorage, AK

Dedra Buchwald, PhD, Director, Washington State University, Spokane, WA

Michael McDonell, PhD, Associate Director, Washington State University, Spokane, WA

Introduction: As part of a randomized controlled trial of contingency management for alcohol use disorders among American Indian/Alaska Native (AI/AN) communities, cultural acceptability of the intervention was maximized through qualitative analysis.

Methods: Nine focus groups were conducted in three AI/AN communities: rural reservation, urban and Alaska area. Respondents included adults in recovery, adults with current drinking problems, medical and service agency providers, and other interested community members (n=61). Focus groups were transcribed and analyzed by two independent coders. An agreed upon hierarchy of themes was created.

Results: Across the three locations individuals who took part in focus groups underscored the importance of providing both culturally specific (e.g., bead work and cultural art work supplies), as well as practical (e.g., gas cards and bus passes) contingency management reinforcers. The importance of involving the entire family was also stressed. Reinforcers aimed at participants’ children including movie tickets, gift cards for family dinners, or other family entertainment opportunities were suggested as a way to reengage with family and rebuild trust that was damaged during alcohol use.

Respondents also indicated that they believed the contingency management intervention supported AI/AN cultural practices and could be expanded to include community recognition, hosting community events where traditional foods are served, and giveaways. The importance of a well-respected community member implementing this intervention to enhance community participation, engagement and longevity of the intervention was also highlighted. Emphasis was placed on use of AI/AN language specific to the tribes and the communities served in addition to the inclusion of cultural symbols and imagery around reinforcers.

Conclusions: Qualitative results suggest that a contingency management intervention for alcohol use disorders is most likely to be effective among AI/ANs when it is delivered in a manner in alignment with existing cultural and community practices, incorporates reinforcers that revitalize cultural participation while simultaneously supporting day-to-day living, and is championed by community leaders.

Abstract: Cultural Adaptation of a Contingency Management Intervention for American Indian and Alaska Native Communities (Society for Prevention Research 25th Annual Meeting)

29 Cultural Adaptation of a Contingency Management Intervention for American Indian and Alaska Native Communities