Studies of Substance Abuse with Interventions for the Youth of Native American Indian Community #15

Universal, selective, and indicated substance abuse prevention programs are all commonly found in American Indian communities. Distinctions between different types of prevention are often blurred; however, as commonly the entire community is considered at risk and is the focus of intervention. Unfortunately, the majority of prevention efforts in Indian Country have not been rigorously evaluated for efficacy. In addition, specific details of these programs often are not published or available in a manner that allows them to be easily shared with other communities. Moran and Reaman (2002) provided information on prevention programs that have not been published in the mainstream literature. Limited program information can also be found through SAMHSA’s Center for Substance Abuse Prevention (2003; see also Western Center for the Application of Prevention Technologies, 2002). While many of these programs have the potential for success in combating Indian adolescent substance abuse and for making valuable contributions to the development of prevention efforts in other communities, this study focuses on reviewing those studies that have been evaluated and published in peer refereed journals.

The principal source of information in this study comes from searches of the MEDLINE and PsycINFO databases. Information on qualitative findings has been included where relevant, although the emphasis here is on presenting quantitative outcome data. The programs reviewed tend to fall into two categories: those that target entire communities for change and those that focus their efforts primarily on individual behavior change.

Several researchers have suggested that programs that target an entire community rather than specific individuals may be more effective for the prevention and treatment of substance abuse in American Indian and Alaskan Native youth (Beauvais & LaBoueff, 1985; E. D. Edwards & Edwards, 1988; Gutierres, Russo, & Urbanski, 1994; LaFromboise, Trimble, & Mohatt, 1990; Petoskey et al., 1998; Wiebe & Huebert, 1996). A community based approach may be preferred for a variety of reasons. Some authors have described the inclusion of an entire community in the intervention as consistent with Native values and traditions, which stress collective decision making in resolving community or tribal concerns (E. D. Edwards & Edwards, 1988; LaFromboise et al., 1990). Others have emphasized the role that sociocultural factors play in the development of drug and alcohol abuse and argued that a more comprehensive approach is necessary to address risk factors at familial and community levels (Gutierres et al., 1994). Most authors agree that whether a curriculum is intended to serve primarily individuals or larger groups, community support for the intervention is vital to the success of any treatment or prevention program (Beauvais & LaBoueff, 1985; E. D. Edwards & Edwards, 1988; LaFromboise et al., 1990; Wiebe & Huebert, 1996).