Thiwáhe Gluwáš’akapi (TG)

Culturally grounded early substance use prevention for American Indian families

Specific aims

  1. Develop a cultur​ally 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.
  2. Pilot the adapted program – Thiwáhe Gluwáš’akapi (TG) – to determine feasibility, refine details, and maximize fit within the community.
  3. 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.
  4. 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.



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). 



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

Centers for American Indian & Alaska Native Health

Colorado School of Public Health

CU Anschutz

Nighthorse Campbell Native Health Building

13055 East 17th Avenue

Mail Stop F800

Aurora, CO 80045

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