Disproportionate rates of substance use disorders (SUDs) have been documented among American Indians (AIs) compared to other populations in the US. Substance use among AI youth often starts earlier than among youth from other racial or ethnic groups, and early use is a significant risk factor for SUDs. Early intervention is critical to reducing substance use disparities in AI communities. The Thiwáhe Gluwáš’akapi Program (TG) for AI youth and families was designed to extend the evidence base of community engaged interventions to reduce substance use disparities among AIs. TG is a culturally adapted version of the Strengthening Families Program for Parents and Youth 10-14 created for AI families living on a reservation in the Northern Plains. This program enrolled families who came together in groups of 5-12 families per group, meeting within their local communities one night a week for seven weeks. Each week included separate adult and youth sessions, focused on building nurturing and effective parenting skills and skills to resist peer pressure for substance use, and joint family sessions. An anticipated outcome of the program was not only the strengthening of relationships between youth and their parents but also the development of new relationships or strengthening of existing across participating families. To examine this, we analyzed: 1) cohesiveness of existing relationships at baseline and 2) change in relationships over time.
Methods: This study used a social network analysis. The focus was on relationships among adults around support for parenting, therefore only adults took the survey (N=137). Approximately, 75% were females. We assessed betweenness, total degree, and density of social networks. We also examined change in the comfort seeking advice and support around parenting.
Results: At baseline, mean betweenness was .20, total degree 3.33, and density .21. At the end of the program, betweenness, degree, and density were 1.0, 6.72, and .34, respectively. Comfort seeking advice and support was 1.47 at baseline and 3.21 after the program (range 1-5). Visual images of social networks, illustrating changes in cohesiveness and characteristics will be presented.
Conclusions: This study highlights the use of social network analysis as a unique analytic tool to assess a secondary outcome of the TG program. This methodology increased our knowledge of a mechanism by which the TG program may influence outcomes, by developing a support system across families participating in the program.