This study explored how a non-targeted group of ethnic minority youth might or might not benefit from a prevention intervention focused on other cultural groups. The study specifically evaluated the effects of an evidence-based drug prevention curriculum with a sample of urban American Indian youth in the southwest U.S., most of whom self-reported multi-ethnic heritages. Using growth curve modeling, this research examined the developmental trajectory of drug use for these youth, and compared it with the trajectory of youth from other racial/ethnic groups at preintervention, post-intervention, and two follow up time periods. Results indicate that alcohol and marijuana use increased from pre-intervention across subsequent time periods for all youth. The drug use of the American Indian youth in the treatment group increased on some measures. Specifically, they reported a steeper trajectory in the amount and frequency of alcohol and marijuana use compared to the youths in the treatment groups with other racial/ethnic identifications. The implications of these findings for the development of culturally grounded prevention programs for multiethnic, urban American Indian youth are discussed. Editors' Strategic Implications: This research provides a specific example, but also makes a strong global argument, for the need to develop and evaluate prevention programs that are culturally grounded in the worldview of the target group.

This exploratory study examines gender differences in the patterns of drug offers among a sample of 71 American Indian middle school students. Participants respond to an inventory of drug-related problem situations specific to the cultural contexts of Southwestern American Indian youth. They are asked to consider the frequency of drug offers from specific groups in their social networks and the difficulty associated with refusing drugs from various offerers. The results indicate that female and male American Indian youth differ in the degree of exposure to drug offers and the degree of perceived difficulty in handling such offers. Even after controlling for differences in age, grade level, socioeconomic status, family structure, and residence on a reservation, girls report significantly more drug offers than boys from friends, cousins, and other peers. Compared to boys, girls also report a significantly higher sense of difficulty in dealing with drug offers from all sources.

This paper describes a five-stage approach toward conducting an ecologically based assessment with Indigenous youth populations, and the implications of this approach for the development and implementation of culturally grounded prevention interventions. A description of a pilot study funded by the National Institutes of Health/National Institute on Drug Abuse (NIH/NIDA) focused on drug use and American Indian youth is presented as one model for operationalizing ecologically based assessment with Indigenous youth populations, and issues related to translating the pilot study into a prevention intervention are discussed. This paper suggests that ecologically based assessment can serve as a foundation for culturally grounded prevention interventions, promoting the social and ecological validity of those interventions.

Symptom management is one of the predominant components of HIV/AIDS care. Frameworks that adequately posses sufficient construct validity and that reflect the symptom experience related to HIV disease, treatment, and medications have been limited. Without validated measures, nurses and other care providers are limited in their ability to accurately assess symptomology and to make appropriate changes to care regimens. The purpose of this article is to demonstrate a method for evaluating symptom status based on the Sign and Symptom Check-List for Persons with HIV disease (SSC-HIV) as well as to provide further support as to the validity of the SSC-HIV. The method to evaluate symptom status that is shown uses a measurement model approach that allows for the assessment of symptom clusters and may be more appropriate than traditional approaches. The sample for this analysis comes from the AIDS Time-Oriented Health Outcome Study. Results further support the SSC-HIV as a valid measure of HIV-related symptoms.