The urgent need for contingency management among Tribal communities in the United States: Considerations for implementation, policy, and sovereignty.

In two randomized controlled trials, culturally adapted contingency management (i.e., incentives provided for substance-negative urine samples) was associated with reduced alcohol and drug use among geographically diverse American Indian and Alaska Native (AI/AN) adults. In response to interest in contingency management from other Tribal and AI/AN communities, our research team in collaboration with AI/AN behavioral health experts, translated the research into practice with new AI/AN community partners. Tenets of community-based participatory research were applied to develop, pilot, and refine contingency management training and implementation tools, and identify implementation challenges. In partnership with the AI/AN communities, four members of the university team developed tools and identified implementation and policy strategies to increase the successful uptake of contingency management in each location. Through our collaborative work, we identified policy barriers including inadequate federal funding of contingency management incentives and a need for further clarity regarding federal anti-kickback regulations. Adoption of contingency management is feasible and can strengthen Tribal communities' capacity to deliver evidence-based substance use disorder treatments to AI/AN people. Unfortunately, non-evidence-based limits to the use of federal funding for contingency management incentives discriminate against AI/AN communities. We recommend specific federal policy reforms, as well as other practical solutions for Tribal communities interested in contingency management.

Community perspectives on drug/alcohol use, concerns, needs, and resources in four Washington State Tribal communities.

Community-university teams investigated substance use, abuse, and dependence (SUAD) and related concerns, needs, strengths, and resources in four Washington State Tribal communities. A total of 153 key community members shared their perspectives through 43 semi-structured interviews and 19 semi-structured focus groups. Qualitative data analysis revealed robust themes: prescription medications and alcohol were perceived as most prevalent and concerning; family and peer influences and emotional distress were prominent perceived risk factors; and SUAD intervention resources varied across communities. Findings may guide future research and the development of much needed strength-based, culturally appropriate, and effective SUAD interventions for American Indians, Alaska Natives, and their communities.

Research partnerships between academic institutions and American Indian and Alaska Native Tribes and organizations: effective strategies and lessons learned in a multisite CTN study.

BACKGROUND: Community Based and Tribally Based Participatory Research (CBPR/TPR) are approaches that can be successful for developing ethical and effective research partnerships between academic institutions and Tribes and Native organizations. OBJECTIVES: The NIDA Clinical Trials Network funded a multi-site, exploratory study using CBPR/TPR to begin to better understand substance abuse issues of concern to some Tribes and Native organizations as well as strengths and resources that exist in these communities to address these concerns. Attention was paid to the development and maintenance of research partnerships in each of the sites. METHODS: Each of the five partnerships is briefly described and common as well as unique challenges and successes are identified. RESULTS: A summary of the common themes for developing these collaborative research efforts is provided. CONCLUSION: True, collaborative research partnerships require a great deal of time and effort in order to develop mutual trust, understanding, knowledge, and collaboration that will guide research that is rigorous as well as ethical, effective, and culturally appropriate. SCIENTIFIC SIGNIFICANCE: As AIAN communities become increasingly sophisticated partners in, and consumers of, research, CBPR and TPR are emerging as effective, ethical, culturally appropriate, and acceptable approaches. This can serve to improve the science we engage in with AIAN communities, add to the scarce literature regarding AIAN communities, and better serve AIAN communities in addressing health disparities and improving health.

An introduction to the 2011 National Multicultural Conference & Summit keynote addresses.

This article provides and introduction to the 2011 National Multicultural Conference & Summit Keynote Addresses. The authors explain that they chose to focus on the tension and possibilities within multicultural psychology at the seventh biennial National Multicultural Conference & Summit (NMCS), which was held on January 27-28, 2011, at The Westin-Seattle Hotel. During the 2-day conference, nearly 900 attendees engaged with one another and heard from experts in the field as we focused on the theme, "Unification through Diversity: Bridging Psychological Science & Practice in the Public Interest. Two key sets of presentations are highlighted.

Healing of the canoe: preliminary results of a culturally tailored intervention to prevent substance abuse and promote tribal identity for Native youth in two Pacific Northwest tribes.

Using Community-based and Tribal Participatory Research (CBPR/TPR) approaches, an academic-tribal partnership between the University of Washington Alcohol and Drug Abuse Institute and the Suquamish and Port Gamble S'Klallam Tribes developed a culturally grounded social skills intervention to promote increased cultural belonging and prevent substance abuse among tribal youth. Participation in the intervention, which used the Canoe Journey as a metaphor for life, was associated with increased hope, optimism, and self-efficacy and with reduced substance use, as well as with higher levels of cultural identity and knowledge about alcohol and drugs among high school-age tribal youth. These results provide preliminary support for the intervention curricula in promoting positive youth development, an optimistic future orientation, and the reduction of substance use among Native youth.

Navigating the Tide Together: Early Collaboration between Tribal and Academic Partners in a CBPR Study.

Community Based Participatory Research (CBPR) approaches stress the importance of building strong, cohesive collaborations between academic researchers and partnering communities; yet there is minimal research examining the actual quality of CBPR partnerships. The objective of the present paper is to describe and explore the quality of collaborative relationships across the first two years of the Healing of the Canoe project teams, comprised of researchers from the University of Washington and community partners from the Suquamish Tribe. Three quantitative/qualitative process measures were used to assess perceptions regarding collaborative processes and aspects of meeting effectiveness. Staff meetings were primarily viewed as cohesive, with clear agendas and shared communication. Collaborative processes were perceived as generally positive, with Tribal empowerment rated as especially important. Additionally, effective leadership and flexibility were highly rated while a need for a stronger community voice in decision-making was noted. Steady improvements were found in terms of trust between research teams, and both research teams reported a need for more intra-team project- and social-focused interaction. Overall, this data reveals a solid CBPR collaboration that is making effective strides in fostering a climate of respect, trust, and open communication between research partners.

Identifying Community Needs and Resources in a Native Community: A Research Partnership in the Pacific Northwest.

Indigenous communities have engaged in needs and resources assessments for thousands of years. By blending CBPR/TPR approaches with community-driven assets and needs assessments, academic and community based researchers can work together to better understand and identify community strengths as well as issues of concern in Native communities. This best practice approach can set research agendas that are relevant to Native communities and result in interventions and health promotion programs that are respectful of Tribal sovereignty and that incorporate unique traditions and strengths of Native communities. A successful research partnership to develop and implement a needs and resources assessment using CBPR/TPR approaches is presented using a case study that can be used as a model for other research partnerships.