Drawing upon Protection from within: Indigenous Intervention Development of the Qungasvik (Toolbox) Prevention Approach for Rural Alaska Native Communities

Introduction: Suicide, often accompanied by alcohol use, is a significant public health concern for Alaska Native people, with youth at highest risk. At the same time, Alaska Native people possess a rich array of strengths based within their traditional culture, which hold promise as effective tools for prevention. The Qungasvik (“koo-ngaz-vick,” tool box) is a culturally grounded, community-based intervention that builds protection against alcohol misuse and suicide risk among Yup’ik Alaska Native youth 12-18 years old (Rasmus, Charles, & Mohatt, 2014). The main purpose of this presentation is to describe the development and implementation of Qungasvik in rural Alaskan communities.

Methods: Qungasvik is a strengths-based Yup’ik community-developed and driven intervention. Qungasvik uses qasgiq (“kuz-gik,” communal house), an Indigenous systems perspective, that facilitates each community constructing its own local adaptation of this community intervention. Based in an Indigenous model of change, the intervention uses local cultural knowledge and expertise, and local staff to build Yup’ik culture-specific protective factors in youth. Its approach and the resulting intervention focuses on providing protective cultural experiences for youth through the strengths and resilience resources within histories rooted in Yup’ik cultural ways of being. Qasgiq references both a historical place and a system of cultural protocols, practices, and organizational strategies. These can be used in culturally grounded intervention design tailored to each distinct, rural Yup’ik community in the Yukon-Kuskokwim region of Alaska.

Results: The Qasgiq Model interacts at multiple systemic levels. On the individual level, it provides youth with important Yup’ik culturally based protective skills, beliefs, and experiences. On the family level, it strengthens families and intergenerational connections. Lastly, on the community level, it moves communities collectively towards interdependence and well-being. The end result is a multi-level intervention that promotes growth in reasons for life (direct protection from suicide) and reasons for sobriety (reflective processes on alcohol consequences that provide direct protection from alcohol use risks). Preliminary outcomes in a prevention trial in four rural Yup’ik communities provide initial evidence of intervention effectiveness.

Conclusions: This presentation provides a description of a Yup’ik cultural process for intervention development. The approach is more broadly illustrative of key basic components of community intervention and prevention program development that leverages protection from within, using local understandings, implementation strategies, and cultural knowledge.