Effects of Alcohol Interventions on Other Drug Use in the Cherokee Nation

Livingston, Melvin D.; Komro, Kelli A.; Wagenaar, Alexander C.; Kominsky, Terrence K.; Pettigrew, Dallas W.; Garrett, Brady A.

doi:10.2105/ajph.2017.304188

Cited by 11 publications

(15 citation statements)

References 12 publications

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“…Several studies have shown the efficacy of Environmental Prevention strategies to reduce community alcohol problems, including underage drinking, by reducing commercial alcohol availability (Holder et al, 2000;Treno, Gruenewald, Lee, & Remer, 2007;Treno & Lee, 2002;Wagenaar, Toomey, & Erickson, 2005). However, few investigators have described interventions on alcohol use among AI/AN youths (see Cheadle et al, 1995;Gabriel, Leichtling, Bolan, & Becker, 2013;Kulis, Ayers, & Harthun, 2017;May & Moran, 1995;Usera, 2017;Wagenaar, Livingston, Pettigrew, Kominsky, & Komro, 2018;Whitesell et al, 2012;Williams & Perry, 1998). A few studies have included AI/ANs in the study design but were not powered to test for effects that might be specific to the AI/AN sample (Livingston et al, 2018;Perry et al, 2000;Perry et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

“…However, few investigators have described interventions on alcohol use among AI/AN youths (see Cheadle et al, 1995;Gabriel, Leichtling, Bolan, & Becker, 2013;Kulis, Ayers, & Harthun, 2017;May & Moran, 1995;Usera, 2017;Wagenaar, Livingston, Pettigrew, Kominsky, & Komro, 2018;Whitesell et al, 2012;Williams & Perry, 1998). A few studies have included AI/ANs in the study design but were not powered to test for effects that might be specific to the AI/AN sample (Livingston et al, 2018;Perry et al, 2000;Perry et al, 1996). In one of those studies, community-level and individual approaches were employed and the 2-year intervention resulted in significant reductions in alcohol use (Komro et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

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2020

AIANMHR

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Programs serving American Indian (AI) youth are an important component of maintaining cultural identity and healthy lifestyles. The current research took a community-engaged approach to evaluate an urban AI youth after-school program that has transitioned into a culturally grounded prevention program. Ways to create a successful research collaboration between AI communities and academics is discussed as well as implications for understanding the importance of culturally-grounded programs for AI youth who reside in urban areas. Overall, the cultural and health components that are integrated into the after-school program were highlighted as primary strengths because they help foster a healthy lifestyle and deeper connection to the heritage/culture for the youth who participated. disconnect from native lands, family members, language, and culture (Brown,

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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2020

AIANMHR

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“…In a previous NIH-funded prevention trial in the Cherokee Nation, we found that an alcohol-focused school-and community-based preventive intervention reduced alcohol use among adolescents, but also had bene cial spillover effects that reduced other drug use, including prescription drug misuse [18,19]. Other prevention trials have also found that involving multiple community systems is effective for the prevention of drug use among adolescents and young adults [20,21].…”

Section: Introductionmentioning

confidence: 92%

Study Protocol For A Cluster Randomized Trial of A School, Family and Community Intervention For Preventing Drug Misuse Among Older Adolescents in the Cherokee Nation

Komro

Kominsky

Skinner

et al. 2021

Preprint

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Background: The national opioid crisis has disproportionately burdened rural White populations and American Indian/Alaska Native (AI/AN) populations. Therefore, Cherokee Nation and Emory University public health scientists have designed an opioid prevention trial to be conducted in rural communities in the Cherokee Nation (northeast Oklahoma) with AI and other (mostly White) adolescents and young adults. Our goal is to implement and evaluate a theory-based, integrated multi-level community intervention designed to prevent the onset and escalation of opioid and other drug misuse. Two distinct intervention approaches—community organizing as implemented in our established Communities Mobilizing for Change and Action (CMCA) intervention protocol, and universal school-based brief intervention and referral, as implemented in our established CONNECT intervention protocol—will be integrated with skill-based training for adults to strengthen social support for youth and strategic media. Further, we will test systems for sustained implementation within existing organizational structures of the Cherokee Nation and local schools and communities. This study protocol describes the cluster randomized trial, designed to measure implementation and evaluate effectiveness on primary and secondary outcomes.Methods: Using a cluster randomized controlled design and constrained randomization, this trial will allocate 20 high schools and surrounding communities to either an intervention or delayed-intervention comparison condition. With a proposed sample of 20 high schools, all enrolled 10th grade students in fall 2021 will be eligible for participation. During the trial, we will: (1) implement interventions through the Cherokee Nation, and measure implementation processes and fidelity; (2) measure opioid and other drug use and secondary outcomes every six months among a cohort of high school students followed over three years through their transition out of high school; (3) test via a cluster randomized trial the effect of the integrated CMCA-CONNECT intervention; and (4) analyze implementation costs. Discussion: This trial will expand upon previous research advancing the scientific evidence regarding prevention of opioid and other drug misuse during the critical developmental period of late adolescent transition to young adulthood among a sample of American Indian and other youth living within the Cherokee Nation reservation.Trial registration: ClinicalTrials.gov, NCT04839978. Registered April 9, 2021, https://clinicaltrials.gov/ct2/show/NCT04839978

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“…This speaks to the broad accessibility of CONNECT to schools with limited support staff, but it also ensures effective delivery of a tested alcohol use prevention program to schools with limited resources. Schools can select key teachers, coaches or support staff to be trained in motivational interviewing and the CONNECT program, and dedicate a portion of the effort to program implementation. CONNECT is appropriate for schools with diverse student populations. CONNECT implementers can be trained to be sensitive and promote student's cultural identity. Although CONNECT was focused on alcohol, reductions in other drug use occurred following implementation . Schools can implement CONNECT for alcohol and other drug prevention.…”

Section: Implications For School Healthmentioning

confidence: 99%

“…• Although CONNECT was focused on alcohol, reductions in other drug use occurred following implementation. 40 Schools can implement CON-NECT for alcohol and other drug prevention.…”

Section: Implications For School Healthmentioning

confidence: 99%

CONNECT: Implementation of a School‐Based Alcohol Screening and Brief Intervention for Youth in the Cherokee Nation

Garrett¹,

Komro

Merlo

et al. 2019

Journal of School Health

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BACKGROUND There is growing optimism regarding the use of screening and brief intervention (SBI) to identify and reduce risk behaviors during adolescence. However, understanding successful SBI implementation remains unclear. We previously reported the effects of CONNECT, a school‐based SBI, on reducing the primary outcome, the rate of monthly alcohol use among primarily American Indian (AI) and White high school students in the Cherokee Nation. In this paper, we describe the design and implementation process for CONNECT. METHOD CONNECT was designed to reduce alcohol use with 2 key strategies: (1) SBI with motivational interviewing (MI), implemented by a school‐based CONNECT coach, and (2) a media campaign. RESULTS Implementation results indicate that during each semester of the 2–1/2 years, between 73% and 100% of eligible students had at least one 15‐minute meeting with a CONNECT coach. Postcards and posters with positive communication tips for parents were displayed in CONNECT communities. No statistically significant differences occurred between the CONNECT and control groups on the hypothesized intermediate outcomes. CONCLUSIONS We describe implementation of a universal, school‐based, culturally adapted SBI that was effective in reducing alcohol use among youth living in the Cherokee Nation. Schools provide an important context for universal delivery of SBI interventions, such as CONNECT, for diverse adolescent populations, including AI youth.

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Effects of Alcohol Interventions on Other Drug Use in the Cherokee Nation

Abstract: Nonalcohol drug use was consistently reduced as a result of 2 theoretically and operationally distinct alcohol prevention strategies. Evaluations of alcohol prevention efforts should continue to include other drug use to understand the broader effects of such interventions.

Cited by 11 publications

References 12 publications

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Study Protocol For A Cluster Randomized Trial of A School, Family and Community Intervention For Preventing Drug Misuse Among Older Adolescents in the Cherokee Nation

CONNECT: Implementation of a School‐Based Alcohol Screening and Brief Intervention for Youth in the Cherokee Nation

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