Despite decades of research as well as concerted efforts to improve prevention and treatment, available information suggests that the prevalence of problematic alcohol and drug use (referred to hereafter as substance use) has not appreciably changed in most American Indian and Alaska Native (AI/AN) communities. Research and health surveillance activities further document the substantial impacts of problematic substance use on the health of AI/AN people at rates that continue to far exceed those of non-AI/ANs. Fortunately, a number of Evidence-Based Practices (EBPs) have now been developed that hold substantial promise for improving treatment for AI/ANs with substance use problems, as they do for non-AIs. Anecdotal reports suggest, however, that the use of EBPs in programs that serve AI/ANs is limited. Furthermore, the unique funding mechanisms for programs serving AI/ANs, as well as the sovereign status of AI/AN tribes, mean that we cannot assume that the factors influencing the implementation of EBPs in programs more generally, such as mandates for the use of EBPs in federally-sponsored programs, impact programs serving this special population in the manner in which they were intended. Organizational factors may also operate differently given the severe fiscal and human resource limitations under which these programs operate. In addition, concerns about the cultural appropriateness of some EBPs may discourage their use.
The specific aims of this project are as follows: 1) to describe the use of specific EBPs in substance abuse treatment programs serving AI/AN communities;2) to describe the factors associated with the decision to implement EBPs in these programs;and 3) to identify methods for more effective dissemination of EBPs to substance abuse treatment programs serving AI/AN communities. We will utilize a three-stage study design. First, we will conduct a focused set of 2 case studies of model substance abuse treatment systems serving AI/AN communities. Second, we will conduct a telephone survey of the directors of all 480 substance abuse treatment programs serving AI/AN communities. Finally, we will conduct in-depth case studies of 12 of these programs. We will collect and analyze both quantitative and qualitative data. The results of this project will provide the first description of the use of EBPs in substance abuse treatment programs serving AI/AN communities, much- needed insights regarding the dynamics around the decision to implement such practices, and carefully formulated methods for more effective dissemination.

Public Health Relevance

The results of this project will provide the first description of the use of Evidence-Based Practices in substance abuse treatment programs serving American Indian and Alaska Native communities. Along with these descriptions, we will also develop a detailed understanding of how these substance abuse treatment programs decide to implement Evidence-Based Practices, and how we could improve our methods for encouraging their use in these programs

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA022239-04
Application #
8016035
Study Section
Special Emphasis Panel (ZRG1-HOP-X (50))
Program Officer
Ducharme, Lori
Project Start
2008-05-15
Project End
2014-02-28
Budget Start
2011-03-01
Budget End
2014-02-28
Support Year
4
Fiscal Year
2011
Total Cost
$374,644
Indirect Cost
Name
University of Colorado Denver
Department
Psychiatry
Type
Schools of Medicine
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Novins, Douglas K; Croy, Calvin D; Moore, Laurie A et al. (2016) Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities. Drug Alcohol Depend 161:214-21
Moore, Laurie A; Aarons, Gregory A; Davis, Jordan H et al. (2015) How do providers serving American Indians and Alaska Natives with substance abuse problems define evidence-based treatment? Psychol Serv 12:92-100
Novins, Douglas K; Green, Amy E; Legha, Rupinder K et al. (2013) Dissemination and implementation of evidence-based practices for child and adolescent mental health: a systematic review. J Am Acad Child Adolesc Psychiatry 52:1009-1025.e18
Whitesell, Nancy Rumbaugh; Beals, Janette; Crow, Cecelia Big et al. (2012) Epidemiology and etiology of substance use among American Indians and Alaska Natives: risk, protection, and implications for prevention. Am J Drug Alcohol Abuse 38:376-82
Legha, Rupinder Kaur; Novins, Douglas (2012) The role of culture in substance abuse treatment programs for American Indian and Alaska Native communities. Psychiatr Serv 63:686-92
Novins, Douglas K; Moore, Laurie A; Beals, Janette et al. (2012) A framework for conducting a national study of substance abuse treatment programs serving American Indian and Alaska native communities. Am J Drug Alcohol Abuse 38:518-22
Novins, Douglas K; Aarons, Gregory A; Conti, Sarah G et al. (2011) Use of the evidence base in substance abuse treatment programs for American Indians and Alaska Natives: pursuing quality in the crucible of practice and policy. Implement Sci 6:63
Kataoka, Sheryl; Novins, Douglas K; DeCarlo Santiago, Catherine (2010) The practice of evidence-based treatments in ethnic minority youth. Child Adolesc Psychiatr Clin N Am 19:775-89