SACRED Connections: A University-Tribal Clinical Research Partnership for School-Based Screening and Brief Intervention for Substance Use Problems among Native American Youth.

Native American (NA) youth report higher rates of alcohol, marijuana, and drug use than U.S. adolescents from any other racial/ethnic group. Addressing this health disparity is a significant research priority across public health, minority health, and dissemination and implementation (D&I) sciences, underscoring the need for empirically-based interventions tailored for NA youth. Effective D&I with NA youth incorporates NA cultural values and involves tribal elders and stakeholders. SACRED Connections (NIDA R01DA02977) was a university-tribal research partnership that utilized a culturally derived Native-Reliance theoretical framework and a community-based participatory research (CBPR) approach. A significant objective of this randomized controlled trial was to close D&I gaps utilizing the RE-AIM Model and National Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care Standards (HHS, 2019). Findings of this 5-year RCT revealed a statistically significant protective relationship between Native Reliance and baseline lifetime and past month alcohol and marijuana use; additionally, the likelihood of reporting marijuana use at 3 months post-intervention was significantly lower among the active condition than among the control condition. Implementation of a developmentally and NA culturally tailored brief protocol revealed: partnering with Native Americans and utilizing CBPR facilitated engagement with this hard-to-reach, underserved community; age and culture are associated with substance use severity among NA teens; a culturally adapted Motivational Interviewing (MI) brief intervention may be effective in reducing marijuana use among NA youth; the Native Reliance theory proved useful as a framework for working with this population; and RE-AIM proved helpful in conceptualizing health equity promoting D&I.

Community partnership to affect substance abuse among Native American adolescents.

BACKGROUND: Substance abuse is one of the nation's primary health concerns. Native American youth experience higher rates of substance abuse than other youth. There is little empirical evidence that exists concerning the use of culturally-based interventions among Native American adolescents. OBJECTIVES: This study used a community-based participatory research approach to develop and evaluate an innovative school-based cultural intervention targeting substance abuse among a Native American adolescent population. METHODS: A two-condition quasi-experimental study design was used to compare the Cherokee Talking Circle (CTC) culturally-based intervention condition (n = 92) with the Be A Winner Standard Education (SE) condition (n = 87). Data were collected at pre-intervention, immediate post-intervention, and 90-day post-intervention using the Cherokee Self-Reliance Questionnaire, Global Assessment of Individual Needs - Quick, and Written Stories of Stress measures. RESULTS: Significant improvements were found among all measurement outcomes for the CTC culturally-based intervention. CONCLUSIONS: The data provide evidence that a Native American adolescent culturally-based intervention was significantly more effective for the reduction of substance abuse and related problems than a noncultural-based intervention. SCIENTIFIC SIGNIFICANCE: This study suggests that cultural considerations may enhance the degree to which specific interventions address substance abuse problems among Native American adolescents.

Principles for establishing trust when developing a substance abuse intervention with a Native American community.

This article traces the development of a research project with a Native American community. Four principles were used to guide the development of the "Community Partnership to Affect Cherokee Adolescent Substance Abuse" project using a community-based participatory research approach. The principles suggest that establishing trust is key when developing and conducting research with a Native American community.

Cherokee self-reliance and word-use in stories of stress.

This study examined the relationship between Cherokee self-reliance and related values expressed through word-use in stories of stress written by Cherokee adolescents. The overall aim of this pilot study was to test the feasibility of using cultural appropriate measurements for a larger intervention study of substance abuse prevention in Cherokee adolescents. A sample of 50 Cherokee adolescent senior high school students completed the Cherokee Self-Reliance Questionnaire and wrote their story of stress. The Linguistic Inquiry and Word Count (LIWC) program, a word-based computerized text analysis software, was used to report the percentage of words used in the selected word categories in relation to all the words used by a participant. Word-use from the stories of stress were found to correlate with Cherokee self-reliance.