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Colorado School of Public Health

 

Thiwáhe Gluwáš’akapi (TG)



In this project, we are working to address the need for evidence-based substance use prevention strategies for American Indian youth by developing and evaluating a family-based, culturally grounded prevention program. 

 In collaboration with community members of a Northern Plains tribe, we have selected a program with strong evidence of effectiveness across a diverse array of other communities – the Strengthening Families Program for Families and Youth 10-14 (SFP 10-14).  We have worked with community advisors to ground SFP 10-14 within Lakota culture, enhancing its relevance and fit for youth and families in this context.  The result is the Thiwáhe Gluwáš’akapi program (translated as sacred home where families are made strong). We are now in the process of implementing and rigorously evaluating Thiwáhe Gluwáš’akapi with family groups around the reservation.  

 This program engages youth aged 10-14 along with their parents and other family members who help parent them (e.g., grandparents, aunties, uncles) for seven weekly meetings.  Each group includes eight to ten youth and their families.  Families begin each weekly meeting by sharing a meal together, then participate in separate youth and parent sessions, and come together again for a family session.  Weekly meetings are designed to:

  • Build on family strengths
  • Encourage appreciation for one another
  • Improve family relationships
  • Decrease family conflict
  • Decrease risky behavior among adolescents

 

The importance of early intervention

Early adolescence is a critical period for the development of substance problems, and early use is a strong predictor of substance use disorder later in life.  Substance use among adolescents is also associated with a constellation of problems during adolescence that threaten successful development and, in the extreme, put adolescents at risk of not surviving to adulthood.  Early substance use is associated with suicide ideation and attempts, early and risky sexual behavior, driving while intoxicated, motor vehicle accidents, school failure, cognitive deficits and alterations in brain morphology and activity, psychopathology, and antisocial behavior (often resulting in criminal activity and incarceration).

 American Indian Risk

American Indian adolescents are at particular risk. Substance use among American Indians often starts earlier compared to others in the U.S., includes earlier use of marijuana, and frequently includes problematic patterns of use (e.g., bingeing).  Reducing substance abuse and other health disparities in these communities may ultimately depend on addressing risk for early use among youth.

 The Evidence Gap

Efforts to prevent early substance use are ongoing in many American Indian communities, but problems persist.  There is very little data on the effectiveness of prevention approaches targeting American Indian youth.  Most programs have no evidence regarding effectiveness with this population.  Communities do the best they can, choosing programs they hope will work, but the lack of evidence hampers effective choices. 

Colorado School of Public Health

13001 E. 17th Place
Mail Stop B119
Aurora, CO 80045


303.724.4585
colorado.sph@ucdenver.edu

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