Alaska Natives face significant health disparities associated with alcohol use disorders and suicide. Elluam Tungiinun is a Yup'ik Eskimo term translatable as """"""""towards wellness."""""""" Elluam Tungiinun (ET) is a culturally-based preventative intervention to reduce suicide risk and co-morbid underage drinking among Alaska Native Yup'ik Eskimo youth. The ET process approach contextualizes its intervention program to the local needs and culture of each rural Alaska community it serves through a set of intensive community co-researcher adaptation process procedures. This proposal seeks funding for a five-year CBPR prevention trial of the ET intervention with 239 youth, ages 12 through 18, in five rural, remote Yup'ik communities. A sample of three communities will test effectiveness two years post intervention using a randomized dynamic wait list control design, along with the fidelity of the ET contextualizing process approach to the intervention model. A sample of 80 will test durability and sustainability of impact over five years in two additional communities with whom we have worked in the past three years developing and piloting the ET intervention. This proposal represents the next stage in a 15-year CPBR process with Alaska Natives. Elluam Tungiinun has three specific aims:
Specific Aim 1 : Test the effectiveness of the ET intervention through contrasts of impact on outcome measures using a randomly assigned, staggered baseline, dynamic wait list control design with three remote, rural AN villages at completion of the intervention.
Specific Aim 2 : Test the fidelity of implementation of the ET toolbox local contextualization approach to the ET intervention model in three communities, and impact of fidelity on outcomes.
Specific Aim 3 : Monitor the sustainability and durability of intervention impact on outcome measures in randomly assigned communities 1- 3 at year 1 and 2 post intervention, and in communities 4- 5, where the intervention was developed and piloted, at year 1-5 post intervention. The ultimate goal of this project is to create evidence-based prevention practices for Alaska Natives. The project has three direct contributions to public health relevance. It seeks to (1) reduce the most significant source of health disparity of public health importance disproportionately affecting Alaska Natives and American Indians, (2) advance CBPR methods in health related research with tribal communities and other ethnic minority, low socioeconomic status, medically underserved, and rural populations, and (3) enhance understanding of factors predictive of health among indigenous and other ethnic minority groups.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Resource-Related Research Projects (R24)
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Special Emphasis Panel (ZMD1-RN (01))
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Goodwin, Paula
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University of Alaska Fairbanks
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United States
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Allen, James; Rasmus, Stacy M; Fok, Carlotta Ching Ting et al. (2018) Multi-Level Cultural Intervention for the Prevention of Suicide and Alcohol Use Risk with Alaska Native Youth: a Nonrandomized Comparison of Treatment Intensity. Prev Sci 19:174-185
Philip, Jacques; Ford, Tara; Henry, David et al. (2016) Relationship of Social Network to Protective Factors in Suicide and Alcohol Use Disorder Intervention for Rural Yup'ik Alaska Native Youth. Interv Psicosoc 25:45-54
Fok, Carlotta Ching Ting; Henry, David; Allen, James (2015) Maybe Small Is Too Small a Term: Introduction to Advancing Small Sample Prevention Science. Prev Sci 16:943-9
Henry, David; Dymnicki, Allison B; Mohatt, Nathaniel et al. (2015) Clustering Methods with Qualitative Data: a Mixed-Methods Approach for Prevention Research with Small Samples. Prev Sci 16:1007-16
Fok, Carlotta Ching Ting; Henry, David; Allen, James (2015) Research Designs for Intervention Research with Small Samples II: Stepped Wedge and Interrupted Time-Series Designs. Prev Sci 16:967-77
Henry, David; Fok, Carlotta Ching Ting; Allen, James (2015) Why Small is Too Small a Term: Prevention Science for Health Disparities, Culturally Distinct Groups, and Community-Level Intervention. Prev Sci 16:1026-32
Allen, James; Hopper, Kim; Wexler, Lisa et al. (2014) Mapping resilience pathways of Indigenous youth in five circumpolar communities. Transcult Psychiatry 51:601-31
Fok, Carlotta Ching Ting; Allen, James; Henry, David et al. (2014) The brief family relationship scale: a brief measure of the relationship dimension in family functioning. Assessment 21:67-72
Allen, James; Mohatt, Gerald V; Fok, Carlotta Ching Ting et al. (2014) A protective factors model for alcohol abuse and suicide prevention among Alaska Native youth. Am J Community Psychol 54:125-39
Rasmus, Stacy M; Charles, Billy; Mohatt, Gerald V (2014) Creating Qungasvik (a Yup'ik intervention ""toolbox""): case examples from a community-developed and culturally-driven intervention. Am J Community Psychol 54:140-52

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