Native Spirit Program for Addiction Prevention

Recruiting at 1 trial location

Overseen By Amanda Hunter, PhD

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: Arizona State University

Disqualifiers: Non-American Indians

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 36

60 Participants Needed

Trial Summary

What is the purpose of this trial?

The proposed research will used community-based participatory research methods in an urban-based American Indian (AI) community to adapt, implement, and evaluate an after-school program, called Native Spirit (NS), that seeks to improve cultural identity, self-esteem, resilience, and prevent substance use by increasing cultural engagement. Prior research suggests that AI youth that are culturally engaged experience better health outcomes. Additionally, the use of culturally-specific after-school programs has been shown to increase feasibility and sustainability of prevention programs. In order to achieve the goals of this proposed study, the Principal Investigator (PI) will work with local community members and existing tribal partners to implement the 10-session culturally-grounded after-school program and evaluate the program with the following aims: Specific Aim 3 (R00): Examine the effectiveness of NS (increases exposure to local cultural values and activities), a program that seeks to prevent or decrease substance use by strengthening self-esteem, resilience, and cultural identity with 2 Indigenous communities in Arizona using a wait-list control design with 3 data collection timepoints and participant interviews.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the Native Spirit After-School Program treatment for addiction prevention?

The Native Spirit After-School Program may be effective for addiction prevention as similar culturally adapted programs, like the Thiwáhe Gluwášk'api Program, have shown promising results in improving communication, resistance skills, and family cohesion among American Indian youth, which are important factors in preventing substance use. ^{1 2 3 4 5}

Is the Native Spirit Program for Addiction Prevention safe for humans?

The Native Spirit Program, which is culturally grounded and developed for American Indian adolescents, has been implemented in partnership with community leaders and cultural practitioners, suggesting a focus on safety and cultural appropriateness. While specific safety data is not detailed, the program's development emphasizes positive impacts on health and well-being, indicating a general consideration for participant safety. ^{6 7 8 9 10}

How is the Native Spirit After-School Program treatment different from other treatments for addiction prevention?

The Native Spirit After-School Program is unique because it is a culturally grounded program specifically designed for American Indian and Alaska Native adolescents, focusing on reconnecting them with their cultural teachings to promote well-being and prevent addiction. Unlike other treatments, it involves local cultural practitioners and community leaders, emphasizing cultural engagement as a form of positive youth development. ^{1 6 7 10 11}

Research Team

Amanda Hunter, PhD

Principal Investigator

Assistant Professor

Eligibility Criteria

The Native Spirit trial is for urban-based American Indian youth. It aims to improve cultural identity, self-esteem, resilience, and prevent substance use through an after-school program. The study focuses on those interested in increasing their cultural engagement.

Inclusion Criteria

English-speaking

Member of the Salt River Pima Maricopa Indian Community (SRPMIC) OR member of the Pascua Yaqui Tribe (PYT)

Engaged in after school programs.

Exclusion Criteria

Non-American Indians will be excluded from statistical analysis

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2 months

Baseline Assessment

Participants complete baseline assessments to gather initial data

1 month

1 visit (virtual or in-person)

Intervention (SRPMIC)

SRPMIC participants receive the Native Spirit program, focusing on Indigenous cultural values and activities

10 weeks

10 sessions (in-person)

Follow-Up Assessment - Time 2 (T2)

Participants complete follow-up assessments to evaluate the impact of the intervention

1 month

1 visit (virtual or in-person)

Participant Interviews

Interviews conducted to gather qualitative data on the impact of the intervention

1 month

1 visit (in-person)

Usual Programming

Both groups receive usual programming focusing on financial wellness

10 weeks

10 sessions (in-person)

Follow-Up Assessment - Time 3 (T3)

Final follow-up assessments to evaluate long-term effects of the intervention

1 month

1 visit (virtual or in-person)

Intervention (PYT)

PYT participants receive the Native Spirit program, focusing on Indigenous cultural values and activities

10 weeks

10 sessions (in-person)

Follow-Up Assessment - Time 3 (T3)

PYT participants complete follow-up assessments to evaluate the impact of the intervention

1 month

1 visit (virtual or in-person)

Participant Interviews

Interviews conducted to gather qualitative data on the impact of the intervention

1 month

1 visit (in-person)

Treatment Details

Interventions

• Native Spirit After-School Program

Trial Overview This trial tests the effectiveness of the 'Native Spirit' after-school program designed to decrease substance use and enhance self-esteem among Indigenous communities by promoting local cultural values. Participants will be compared with a wait-list control group over three data collection points.

Participant Groups

Group I: Intervention Group Experimental Treatment 1 Intervention

The intervention group will receive the intervention (Native Spirit after-school program). Each intervention session is based on an Indigenous cultural value and cultural activity/practice that is specific to the community. The intervention is 10, 1.5 hour sessions that occur once/week from January-May 2025. After the Crossover the Intervention group will engage in "usual programming" August-December 2025.

Group II: Wait-List Group Active Control 1 Intervention

The wait-list group will receive control or "usual" programming. Usual programming includes a life skills program that focuses on financial wellness for teens, called "Money Matters" (Usual Practice). Participants will learn valuable financial life skills. Control sessions will be facilitated by the research site partner (after-school program employees) who typically implement their usual programming. Control sessions will be held at the research site. Each control session will last for 60-90 minutes, once a week for 10 weeks taking place from August 2025 - December 2025 After the Crossover the wait-list group will receive the intervention January-May 2026.

Who Is Running the Clinical Trial?

Arizona State University

Lead Sponsor

Trials

311

Recruited

109,000+

Findings from Research

The Thiwáhe Gluwáš'akapi Program (TG) was culturally adapted for American Indian youth and showed significant improvements in key areas such as parental communication about substance use and youth resistance skills, indicating its potential effectiveness in preventing early substance use.

Both youth and adults reported positive changes in family dynamics and overall well-being, suggesting that the program not only addresses substance use prevention but also strengthens family relationships, which are crucial for supporting healthy development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Grounding evidence-based prevention within cultural context: promising effects of substance use prevention adapted for American Indian families. Asdigian, NL., Tuitt, N., Mousseau, AC., et al.[2023]

In a study involving 30 American Indians who completed a residential substance abuse treatment program, participants showed significant reductions in drinking and drug use six months after receiving monthly telephone aftercare support.

The aftercare program also led to fewer encounters with the criminal justice system and improved familial and social relationships, indicating its effectiveness in supporting long-term recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Substance abuse treatment outcomes among American Indians in the Telephone Aftercare Project. Chong, J., Herman-Stahl, M.[2019]

A study of 160 adolescent inpatients followed for up to 8 years found that early attendance at Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) is common and linked to better long-term recovery outcomes, despite a decline in attendance over time.

Youth with more severe addiction issues were more likely to attend AA/NA, suggesting that these organizations play a crucial role in supporting recovery, especially for those who struggle with substance use.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social recovery model: an 8-year investigation of adolescent 12-step group involvement following inpatient treatment. Kelly, JF., Brown, SA., Abrantes, A., et al.[2022]

Contingency management (CM) interventions significantly increased the likelihood of alcohol abstinence among American Indian adults with alcohol dependence, with odds ratios ranging from 2.4 to 4.8 compared to a control group that only received incentives for submitting urine samples.

While CM for drug abstinence showed some positive effects, the results were inconclusive in the analysis, indicating that while CM can effectively promote alcohol abstinence, its impact on drug abstinence needs further investigation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The rewarding recovery study: a randomized controlled trial of incentives for alcohol and drug abstinence with a rural American Indian community. McDonell, MG., Skalisky, J., Burduli, E., et al.[2022]

The Asdzáán Be'eená program, designed for Navajo girls aged 8 to 11 and their caregivers, showed promising results in increasing self-esteem, self-efficacy, and cultural knowledge, as well as improving parent-child relationships and communication after 3 months.

Caregivers also reported enhanced family engagement in Navajo culture and better child functioning, indicating that the program may effectively reduce risk factors for substance use and teen pregnancy in Native communities, although further rigorous studies are needed to confirm its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility, Acceptability, and Preliminary Impact of Asdzáán Be'eená: An Intergenerational, Strength-Based, and Culturally Grounded Program to Improve the Health of Navajo Families. Chambers, RA., Patel, H., Richards, J., et al.[2023]

The Native Spirit after-school program, developed for American Indian and Alaska Native adolescents, consists of 13 sessions that reconnect youth with their cultural teachings, promoting health and well-being.

Implemented through a partnership with local cultural practitioners and the Boys & Girls Club, this program highlights the positive impact of Indigenous culture on youth development and community health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Native Spirit: Development of a culturally grounded after-school program to promote well-being among American Indian adolescents. Hunter, AM., Carlos, M., Nuño, VL., et al.[2022]

Among 243 Native American middle school students, those with a stronger sense of belonging at school reported significantly lower lifetime and recent use of alcohol, cigarettes, and marijuana.

Students with a strong school connection also initiated drug use at a later age compared to their peers, highlighting the importance of a supportive school environment in substance use prevention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sense of Belonging in School as a Protective Factor Against Drug Abuse Among Native American Urban Adolescents. Napoli, M., Marsiglia, FF., Kulis, S.[2022]

The Talking Circle intervention significantly improved Native-Reliance among 75 Native American participants aged 18-24, indicating a positive cultural impact on their well-being.

At 6 months post-intervention, participants showed significant reductions in stress, behavioral health issues, substance use, depression, and cumulative trauma, demonstrating the effectiveness of culturally safe interventions in addressing trauma-related issues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Talking Circle For Young Adults (TC4YA) intervention: a culturally safe research exemplar. Lowe, J., Millender, E., Best, O.[2022]

American Indian youth exhibit significantly higher rates of drug use compared to their non-Indian peers, with about 20% of Indian adolescents remaining heavily involved with drugs, a statistic that has not changed since 1980.

The trends in drug use among Indian youth mirror those of non-Indian youth, suggesting that effective prevention strategies used for other populations could also be beneficial for American Indian youth, especially among school dropouts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Trends in drug use among American Indian students and dropouts, 1975 to 1994. Beauvais, P.[2019]

The Journeys of the Circle Project focuses on culturally appropriate substance prevention and intervention strategies specifically designed for American Indian and Alaska Native (AIAN) communities, addressing a critical need in schools and communities.

Previous interventions for reducing substance misuse in these communities have largely been unsuccessful, highlighting the importance of integrating historic cultural traditions into new prevention programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Journeys of the Circle: a culturally congruent life skills intervention for adolescent Indian drinking. Marlatt, GA., Larimer, ME., Mail, PD., et al.[2015]

AIAN communities are increasingly taking control of their own substance abuse prevention programs, highlighting the importance of culturally relevant approaches rather than simply adapting European American practices.

The review categorizes AIAN substance abuse prevention efforts into three groups: empirical trials, promising programs under development, and innovative grassroots initiatives, emphasizing the need for recognition and support of these local efforts.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Substance abuse prevention in American Indian and Alaska Native communities. Whitbeck, LB., Walls, ML., Welch, ML.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Grounding evidence-based prevention within cultural context: promising effects of substance use prevention adapted for American Indian families. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Substance abuse treatment outcomes among American Indians in the Telephone Aftercare Project. [2019]

3. England pubmed.ncbi.nlm.nih.gov

Social recovery model: an 8-year investigation of adolescent 12-step group involvement following inpatient treatment. [2022]

4. England pubmed.ncbi.nlm.nih.gov

The rewarding recovery study: a randomized controlled trial of incentives for alcohol and drug abstinence with a rural American Indian community. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Feasibility, Acceptability, and Preliminary Impact of Asdzáán Be'eená: An Intergenerational, Strength-Based, and Culturally Grounded Program to Improve the Health of Navajo Families. [2023]

6. England pubmed.ncbi.nlm.nih.gov

Native Spirit: Development of a culturally grounded after-school program to promote well-being among American Indian adolescents. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Sense of Belonging in School as a Protective Factor Against Drug Abuse Among Native American Urban Adolescents. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Talking Circle For Young Adults (TC4YA) intervention: a culturally safe research exemplar. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

Trends in drug use among American Indian students and dropouts, 1975 to 1994. [2019]

10. England pubmed.ncbi.nlm.nih.gov

Journeys of the Circle: a culturally congruent life skills intervention for adolescent Indian drinking. [2015]

11. England pubmed.ncbi.nlm.nih.gov

Substance abuse prevention in American Indian and Alaska Native communities. [2023]