Thiwáhe Gluwáš’akapi (TG)
Culturally grounded early substance use prevention for American Indian families
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Description
This project built on findings from EAST (R01DA027665) and the urgings of community advisors to move from documenting early initiation of substance use among their youth to engaging with families in their community to prevent it. Working with these advisors, we chose a prevention program with strong evidence of effectiveness in other populations (the Strengthening Families Program for Parents and Youth 10-14) and adapted it based on cultural teachings and research findings to for youth and families on this Northern Plains reservation. We used a Multiphase Optimization Strategy design to compare adaptation components to select the best array to include in the final program, called Thiwáhe Gluwáš’akapi (sacred home in which family is made strong).
Specific aims
- Develop a culturally grounded, family-based early substance use prevention intervention tailored to a Northern Plains American Indian reservation.
- Use an evidence-based program approach to implement a proven program (Iowa Strengthening Families Program).
- Ground evidence-based program within American Indian culture, using local cultural teachings as the context for delivery of the intervention.
- Pilot the adapted program – Thiwáhe Gluwáš’akapi (TG) – to determine feasibility, refine details, and maximize fit within the community.
- Test the adapted program, using the principles of the Multiphase Optimization Strategy for intervention evaluation and development to determine the relative effect sizes of intervention components and inform a final TG program that balances effectiveness and efficiency.
- Set the stage for a randomized controlled trial of the full intervention and, eventually, the broad, sustainable implementation of TG by the tribal health administration.
Outcomes
This study resulted in the creation of an optimized Thiwáhe Gluwáš’akapi prevention program that is now being tested in a randomized controlled trial (TG2, also known as the Strong Lakota Families Study), funded by the NIDA (R37DA047926; Whitesell, PI).
Publications
Two papers have been published reporting on the adaptation process in this study:
Whitesell, N.R., Mousseau, A.C., Keane, E.M., Asdigian, N.L., Tuitt, N., Morse, B., Zacher, T, Dick, R., Mitchell, C.M. and Kaufman, C.E. (2019). Integrating community engagement and a multiphase optimization framework: Adapting substance use prevention for American Indian families. Prevention Science, 20(7), 1136-1146. doi: 10.1007/s11121-019-01036-y
Ivanich, J., Mousseau, A.C., Walls, M., Whitbeck, L., & Whitesell, N.R. (2020). Pathways of adaptation: Two case studies with one evidence-based substance use prevention program tailored for Indigenous youth. Prevention Science, 21(Suppl 1), 43-3. doi: 10.1007/s11121-018-0914-5
Other papers related to this study:
Whitesell, N.R. & Kaufman, C.E. (2017). Substance use disorders among Indigenous youth in developmental perspective: Critical lessons in diversity, diagnostic tools, and resilience. Journal of the American Academy of Child and Adolescent Psychiatry, 56(2), 103-104. doi: 10.1016/j.jaac.2016.12.005
Whitesell, N.R., Sarche, M., Keane, E.M., Mousseau, A.C. and Kaufman, C.E. (2018). Advancing Scientific Methods in Community and Cultural Context to Promote Health Equity: Lessons from Intervention Outcomes Research with American Indian and Alaska Native Communities. American Journal of Evaluation, 39(1), 42-57. doi: 10.1177/1098214017726872
Whitesell, N.R., Mousseau, A.C., Parker, M., Rasmus, S., and Allen, J. (2020). Promising practices for promoting health equity through rigorous intervention science with Indigenous communities. Prevention Science, 21(Suppl 1) 5-12. doi: 10.1007/s11121-018-0954-x
Rasmus, S., Whitesell, N.R., Mousseau, A.C., & Allen, J. (2020). An intervention science to advance underrepresented perspectives and Indigenous self-determination in health. Prevention Science, 21(Suppl 1) 83-92. doi: 10.1007/s11121-019-01025-1