Connect: Implementation and Process Outcomes of a School-Based Alcohol Screening and Brief Intervention for Youth in Cherokee Nation

Introduction: There is growing optimism with the use of Screening and Brief Intervention (SBI) to identify and subsequently reduce alcohol use and associated risks during adolescence. The effects of CONNECT, a school-based SBI, on reducing the rate of monthly alcohol use among high school students in the Cherokee Nation have been reported previously. In this presentation, we present on the design, implementation processes and outcomes, and the intermediate outcome (e.g., alcohol expectancies, social support, and parent communication) for CONNECT.

Methods: CONNECT was designed to reduce alcohol use with two key strategies: (a) SBI with Motivational Interviewing (MI), implemented by a school-based CONNECT Coach, and (b) a media campaign for parents. To test intermediate outcomes, a brief survey was administered quarterly each year of the CONNECT intervention. Generalized estimating equations were used to test intervention effects and estimated as the difference in slopes between students receiving CONNECT compared to controls.

Results: Implementation results show that during each semester of the 2.5 years of CONNECT, between 73% to 100% of eligible students had at least one 15-minute meeting with a CONNECT coach. CONNECT coach skills in motivational interviewing improved over the intervention period. Postcards and posters with positive communication tips were displayed in the CONNECT communities. However, observed differences on the measured intermediate outcomes between the CONNECT and control groups were not statistically significant.

Conclusions: This presentation described the successful implementation processes of a universal, school-based, SBI that was effective in reducing alcohol use among youth living in rural communities located in the Cherokee Nation. Measured intermediate outcomes were not significant, suggesting that the intervention worked through other mediators.