Introduction Substance use represents a significant and persistent health disparity among Native Hawaiian youth and communities. A community-university participatory action research project was conducted to develop a Native Hawaiian model of drug prevention. Methods Ten youth participated in eight Photovoice focus groups. Focus group transcripts and the youths’ SHOWED (see, happening, our, why, empower, do) worksheets were analyzed. Results Emergent analyses are described regarding focus group theme identification and the meaning of each theme. Youth-selected exemplary photographs and researcher-selected exemplary quotations are provided. Implications Native Hawaiian drug prevention will be place-based in culturally significant community locations, experiential, and guided by multigenerational teaching and learning.