Methods: A total of four focus groups were conducted in two American Indian communities: an urban Indian Center and a rural reservation. Participants were emerging adults (18-29 year old) in recovery as well as family members (n=32). Focus group questions were related to younger American Indian adults’ interest in CM, cultural adaptation of CM, and interest in CM relative to other available treatments or culturally grounded approaches. Focus groups were audio-recorded, transcribed, and independently coded and analyzed by two study team members.
Results: The focus groups consisted of thirteen tribal nations. The sample was primarily male, high school graduates, living with family and unemployed. Eight people on average participated in each focus group and the transcript length was on average sixteen pages. Four overarching themes emerged: 1) interest in CM for younger American Indian adults; 2) importance of culture; 3) potential treatment barriers; and 4) marketing and outreach to engage younger American Indian adults and the community in a recovery environment.
Conclusion: Findings suggest that younger American Indian adults are interested in CM to address AUDs. Prizes, cultural activities, and activities that capture the attention of young adults should be integrated into the CM intervention to enhance intervention engagement. Challenges to retention and engagement among American Indian young adults included: transportation, social networks and peer-support. These results underscore the need for continued research in how to better meet the treatment needs of younger American Indian people.