This article describes the relevance of a culturally grounded approach toward drug prevention development for indigenous youth populations. This approach builds drug prevention from the “ground up” (ie, from the values, beliefs, and worldviews of the youth that are the intended consumers of the program), and is contrasted with efforts that focus on adapting existing drug prevention interventions to fit the norms of different youth ethnocultural groups. The development of an empirically based drug prevention program focused on rural Native Hawaiian youth is described as a case example of culturally grounded drug prevention development for indigenous youth, and the impact of this effort on the validity of the intervention and on community engagement and investment in the development of the program are discussed. Finally, implications of this approach for behavioral health services and the development of an indigenous prevention science are discussed.

This study examined the gender differences in preferred strategies used to resist drugs and alcohol for rural Native Hawaiian youth. Seventy-four youth (60% female) within eight different middle/intermediate or high schools participated in 15 different focus groups as part of a pilot/feasibility drug prevention study funded by the National Institute on Drug Abuse. Consistent with relational-cultural theory, qualitative findings indicated how female youth participants favored drug resistance strategies that maintained relational connectedness with the drug offerer, and how they considered the long-term relational consequences of different drug resistance strategies. Implications of these findings for indigenous- and gender-specific prevention are discussed.

This study examines gender differences in the use of drug resistance strategies for rural Asian/Pacific Islander youth. Multi-ethnic Asian/Pacific Islander youth (N = 213) from 6 middle/intermediate schools on the Island of Hawai’i participated in the study, and gender differences in their real-world use of specific strategies (e.g., refuse, explain, avoid, leave) were examined. Despite similar levels of exposure to situations where drugs and/or alcohol were offered, girls indicated significantly lower usage of most of the resistance strategies compared to boys, suggesting girls’ increased risk in dealing with drug-related problem situations. Implications for gender-and culture-specific health promotion and drug prevention curricula are discussed.