Citation

Baldwin JA, Lowe J, Brooks J, Charbonneau-Dahlen BK, Lawrence G, Johnson-Jennings M, Padgett G, Kelley M, Camplain C. Health Promot. Pract. 2021; 22(6): 778-785.

Copyright

(Copyright © 2021, Society for Public Health Education, Publisher SAGE Publishing)

DOI

10.1177/1524839920918551

PMID

32406286

PMCID

PMC7666030

Abstract

Background. Substance use among American Indians (AIs) is a critical health issue and accounts for many health problems such as chronic liver disease, cirrhosis, behavioral health conditions, homicide, suicide, and motor vehicle accidents. In 2013, the highest rates of substance use and dependence were seen among AIs when compared to all other population groups, although these rates vary across different tribes. Among AI adolescents, high rates of substance use have been associated with environmental and historical factors, including poverty, historical trauma, bicultural stress, and changing tribal/familial roles. Our project, the Intertribal Talking Circle intervention, involved adapting, tailoring, implementing, and evaluating an existing intervention for AI youth of three tribal communities in the United States. Formative Results. Community partnership committees (CPCs) identified alcohol, marijuana, and prescription medications as high priority substances. CPC concerns focused on the increasing substance use in their communities and the corresponding negative impacts on families, stating a lack of coping skills, positive role models, and hope for the future as concerns for youth. Cultural Tailoring Process Results. Each site formed a CPC that culturally tailored the intervention for their tribal community. This included translating Keetoowah-Cherokee language, cultural practices, and symbolism into the local tribal customs for relevance. The CPCs were essential for incorporating local context and perceived concerns around AI adolescent substance use. These results may be helpful to other tribal communities developing/implementing substance use prevention interventions for AI youth. It is critical that Indigenous cultures and local context be factored into such programs.

Language: en

Keywords

Humans; United States; Adolescent; Culture; Suicide; Substance-Related Disorders; health research; Indians, North American; substance abuse; cultural competence; community intervention; health disparities; community-based participatory research; minority health; American Indian or Alaska Native; formative evaluation; child/adolescent health; Native American/American Indian; partnerships/coalitions; program planning and evaluation