Culturally Responsive Opioid and Other Drug Prevention for American Indian/Alaska Native People: a Comparison of Reservation- and Urban-Based Approaches

• Type of Material: Article
• Authors: Kelli Komro, Emory University; Elizabeth J D'Amico, RAND Corporation; Daniel L Dickerson, University of California Los Angeles; Juli R Skinner, Cherokee Nation Behavioral Health; Carrie L Johnson, Sacred Path Indigenous Wellness Center; Terrence K Kominsky, Cherokee Nation Behavioral Health; Kathy Etz, National Institute On Drug Abuse, North Bethesda
• Language: English
• Date: 2022-06-24
• Publisher: SPRINGER/PLENUM PUBLISHERS
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1007/s11121-022-01396-y
• Title of Journal or Parent Work: PREVENTION SCIENCE
• Start Page: 1
• End Page: 11
• Grant/Funding Information: Research was supported by UH3DA050234 (Komro, Skinner & Kominsky) and UH3DA050235 (D’Amico & Dickerson) from the National Institute on Drug Abuse.
• Keywords: TRIAL; ABUSE; Public, Environmental & Occupational Health; INTERVENTION; PROTECTIVE FACTORS; Drug prevention; American Indian/Alaska Native people; OUTCOMES; ADOLESCENTS; Life Sciences & Biomedicine; HEALTH; ALCOHOL-USE; COMMUNITY; Culturally responsive; SUICIDE; Science & Technology
• Research Categories: Health Sciences, Epidemiology

Abstract

There are few substance use treatment and prevention programs for AI/AN people that integrate culturally based practices with evidence-based treatment and prevention. The National Institutes of Health’s (NIH’s) Helping to End Addiction Long-term (HEAL) Prevention Cooperative supports two projects focused on AI/AN populations. One focuses on youth ages 15 to 20 years living within the Cherokee Nation reservation, a multicultural rural area in northeastern Oklahoma, and the second focuses on emerging adults ages 18 to 25 years living in diverse urban areas. We provide a brief overview of the two prevention trials and a case comparison across approaches using the framework of promising practices for intervention science with Indigenous communities (Whitesell et al., 2020) related to (1) integration of Indigenous and academic perspectives to respond to community needs, (2) community partnership and engagement, (3) alignment with Indigenous cultural values and practices, (4) capacity building and empowerment, (5) implementation within complex cultural contexts, and (6) tribal oversight. Overall, these two projects highlight the importance of long-standing relationships with community partners, engaging the community at all levels to ensure that programming is culturally and developmentally appropriate, and having tribal and elder oversight. These practices are key to establishing trust and building confidence in research in these communities and ensuring that research can benefit AI/AN people. These studies showcase how strong partnerships can advance health and support the conduct of rigorous science to help pinpoint optimal health solutions by identifying efficacious, culturally grounded intervention strategies. Although the sovereign status of tribes demands this type of partnership, this research serves as a model for all community research that has a goal of improving health.