TY - JOUR
T1 - Multi-Level Cultural Intervention for the Prevention of Suicide and Alcohol Use Risk with Alaska Native Youth
T2 - a Nonrandomized Comparison of Treatment Intensity
AU - Qungasvik Team
AU - Allen, James
AU - Rasmus, Stacy M.
AU - Fok, Carlotta Ching Ting
AU - Charles, Billy
AU - Henry, David
N1 - Publisher Copyright:
© 2017, Society for Prevention Research.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Suicide and alcohol use disorders are primary determinants of health disparity among Alaska Native people in contrast to the US general population. Qungasvik, a Yup’ik word for toolbox, is a strengths-based, multi-level, community/cultural intervention for rural Yup’ik youth ages 12–18. The intervention uses “culture as intervention” to promote reasons for life and sobriety in young people using local expertise, high levels of community direction, and community based staff. The intervention is grounded in local practices and adaptive to local cultural differences distinctive to rural Yup’ik communities. The current study compares the effectiveness of high-intensity intervention in one community (treatment), operationalized as a high number of intervention activities, or modules, implemented and attended by youth, contrasted to a lower intensity intervention in a second community (comparison) that implemented fewer modules. A Yup’ik Indigenous theory of change developed through previous qualitative and quantitative work guides intervention. In the model, direct intervention effects on proximal or intermediate variables constituting protective factors at the individual, family, community, and peer influences levels lead to later change on the ultimate prevention outcome variables of Reasons for Life protective from suicide risk and Reflective Processes about alcohol use consequences protective from alcohol risk. Mixed effects regression models contrasted treatment and comparison arms, and identified significant intervention effects on Reasons for Life (d = 0.27, p < .05) but not Reflective Processes.
AB - Suicide and alcohol use disorders are primary determinants of health disparity among Alaska Native people in contrast to the US general population. Qungasvik, a Yup’ik word for toolbox, is a strengths-based, multi-level, community/cultural intervention for rural Yup’ik youth ages 12–18. The intervention uses “culture as intervention” to promote reasons for life and sobriety in young people using local expertise, high levels of community direction, and community based staff. The intervention is grounded in local practices and adaptive to local cultural differences distinctive to rural Yup’ik communities. The current study compares the effectiveness of high-intensity intervention in one community (treatment), operationalized as a high number of intervention activities, or modules, implemented and attended by youth, contrasted to a lower intensity intervention in a second community (comparison) that implemented fewer modules. A Yup’ik Indigenous theory of change developed through previous qualitative and quantitative work guides intervention. In the model, direct intervention effects on proximal or intermediate variables constituting protective factors at the individual, family, community, and peer influences levels lead to later change on the ultimate prevention outcome variables of Reasons for Life protective from suicide risk and Reflective Processes about alcohol use consequences protective from alcohol risk. Mixed effects regression models contrasted treatment and comparison arms, and identified significant intervention effects on Reasons for Life (d = 0.27, p < .05) but not Reflective Processes.
KW - Alcohol
KW - American Indian/Alaska Native
KW - Community intervention
KW - Community-based participatory research
KW - Suicide
UR - http://www.scopus.com/inward/record.url?scp=85026918329&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85026918329&partnerID=8YFLogxK
U2 - 10.1007/s11121-017-0798-9
DO - 10.1007/s11121-017-0798-9
M3 - Article
C2 - 28786044
AN - SCOPUS:85026918329
SN - 1389-4986
VL - 19
SP - 174
EP - 185
JO - Prevention Science
JF - Prevention Science
IS - 2
ER -