Scott K. Okamoto

The efficacy of a multicultural prevention intervention among urban American Indian youth in the southwest U.S.

This study explored how a non-targeted group of ethnic minority youth might or might not benefit from a prevention intervention focused on other cultural groups. The study specifically evaluated the effects of an evidence-based drug prevention curriculum with a sample of urban American Indian youth in the southwest U.S., most of whom self-reported multi-ethnic heritages. Using growth curve modeling, this research examined the developmental trajectory of drug use for these youth, and compared it with the trajectory of youth from other racial/ethnic groups at pre-intervention, post-intervention, and two follow up time periods. Results indicate that alcohol and marijuana use increased from pre-intervention across subsequent time periods for all youth. The drug use of the American Indian youth in the treatment group increased on some measures. Specifically, they reported a steeper trajectory in the amount and frequency of alcohol and marijuana use compared to the youths in the treatment groups with other racial/ethnic identifications. The implications of these findings for the development of culturally grounded prevention programs for multi-ethnic, urban American Indian youth are discussed. Editors’ Strategic Implications: This research provides a specific example, but also makes a strong global argument, for the need to develop and evaluate prevention programs that are culturally grounded in the worldview of the target group.

A Review of the Literature on Native Hawaiian Youth and Drug Use: Implications for Research and Practice

This article provides a comprehensive review of the recent literature on Native Hawaiian youth and substance use. Eight-hundred and twelve potential articles pertaining to Native Hawaiian youth and substance use published between 1995 to May 2009 were identified through an exhaustive literature search. The total number of articles was reduced to 32 articles, which were systematically coded and content analyzed. The findings indicated that the majority of studies focused on epidemiology, with relatively few of them focused on causal factors/etiology and systematic program development or evaluation. Gender differences in drug use were highlighted in several studies. Implications for culturally tailored interventions and future research are discussed.

Family Influences on Alcohol and Drug Use by American Indian Youth: Implications for Prevention

ABSTRACT Extensive research has focused on risk factors for and social influences on alcohol and drug use by adolescents. While peers tend to be most the influential, parents and families are also important, with specific parental behaviors and particular family dynamics identified in the literature as having a protective or risk effect on youth. However, this line of research has not examined the differences in family influence on youth of various ethnic and cultural backgrounds. This qualitative research study of American Indian adolescents identified both positive and negative influences on youth substance use by various family members within kinship groups. The widespread influence of specific kinship members on high-risk behaviors of American Indian youth has not been previously identified. These findings have significant implications for alcohol and drug prevention and intervention activities with American Indian youth.

Interagency Collaboration with High-Risk Gang Youth.

This study examines the process of collaboration between agencies working with high-risk gang youth. Using semi-structured interviews with direct practitioners and observations of a collaborative event at a juvenile prison, this theory-generating study examined the strengths of and barriers to collaboration between adolescent-serving agencies. Practitioners indicated the importance of communication and cooperation as elements of a successful collaboration. In practice, however, these elements were often replaced by premature termination of collaborative arrangements, blaming other agencies for failure of youth, and diffusion of responsibility (“passing the buck”). This study proposes agency fear as a factor separating desired from actual practice, and proposes potential causes and outcomes of agency fear.

A Continuum of Approaches Toward Developing Culturally Focused Prevention Interventions: From Adaptation to Grounding

The purpose of this article is to describe a conceptual model of methods used to develop culturally focused interventions. We describe a continuum of approaches ranging from non-adapted/surface-structure adapted programs to culturally grounded programs, and present recent examples of interventions resulting from the application of each of these approaches. The model has implications for categorizing culturally focused prevention efforts more accurately, and for gauging the time, resources, and level of community engagement necessary to develop programs using each of the different methods. The model also has implications for funding decisions related to the development and evaluation of programs, and for planning of participatory research approaches with community members.

The development and initial validation of the Hawaiian Youth Drug Offers Survey (HYDOS)

Objective. This study describes the development and preliminary validation of a survey focused on the most salient situations where drugs and/or alcohol are offered to Native Hawaiian youth in rural communities. Design. The study used a five-phase approach to test development and validation. In Phase 1 (item generation), survey items were created from a series of focus groups with middle school aged youth (n=47). In Phase 2 (item refinement and selection), items were edited and reduced to 62 drug-offer situations that were selected for inclusion in the survey. In Phase 3 (item reduction), items were administered to 249 youth from seven middle or intermediate schools in Hawai‘i. Results. Exploratory factor analysis of the Native Hawaiian subsample (n=194) indicated the presence of three factors accounting for 63% of the variance: peer pressure (23%); family offers and context (21%); and unanticipated drug offers (19%). The survey items differentiated between Hawaiian and non-Hawaiian youth respondents, supporting the validity of the questionnaire. The hypothesized relationship between cultural connectedness and drug offer exposure was not confirmed. Internal consistency of the measure was high. Conclusions. The survey helps to fill the gap in information related to drug use of Native Hawaiian youth and has implications for the development and assessment of culturally-specific drug prevention programs for these youth.

The Implications of Ecologically Based Assessment for Primary Prevention with Indigenous Youth Populations

This paper describes a five-stage approach toward conducting an ecologically based assessment with Indigenous youth populations, and the implications of this approach for the development and implementation of culturally grounded prevention interventions. A description of a pilot study funded by the National Institutes of Health/National Institute on Drug Abuse (NIH/NIDA) focused on drug use and American Indian youth is presented as one model for operationalizing ecologically based assessment with Indigenous youth populations, and issues related to translating the pilot study into a prevention intervention are discussed. This paper suggests that ecologically based assessment can serve as a foundation for culturally grounded prevention interventions, promoting the social and ecological validity of those interventions. Editors’ Strategic Implications: By basing the intervention components on assessments of population needs and abilities, the authors demonstrate how programs may be responsive to participants embedded in specific cultural contexts. This type of forward engineering changes the focus of adaptation to program development and should serve as a model for all those developing interventions as well as those working to adapt effective programs to meet the needs of specific populations.

Community Risk and Resiliency Factors Related to Drug Use of Rural Native Hawaiian Youth: An Exploratory Study

This exploratory, qualitative study examined the community-based risk and resiliency factors related to the drug use of rural Native Hawaiian youth. Forty-seven youth from five middle schools participated in focus groups that examined the ecological context of drug use for rural Hawaiian youth. Findings indicated that youth in the study were part of large extended networks of families and that these networks became a defining characteristic of the rural communities in the study. These familial networks functioned as sources of risk and protection related to drug use for youth participants. Implications for community-based practice are discussed.

The Effect of Neighborhood Context on the Drug Use of American Indian Youth of the Southwest

SUMMARY This study examined neighborhood effects on the drug use of American Indian youth of the Southwest. We compared these effects with American Indian and non-American Indian youth in order to examine the universality of neighborhood disorganization as a risk factor for drug use. Neighborhood level variables included unemployment, poverty, education, and violent crime rate. Results indicated that American Indian youth were not as adversely affected by these neighborhood factors. American Indian youth may possess cultural characteristics that protect them from the adverse effects of neighborhood disorganization, including close familial relationships and ethnic pride. Culturally competent practice with American Indian youth may best be implemented through the enhancement of relational and cultural strengths as described in the literature.

A Typology and Analysis of Drug Resistance Strategies of Rural Native Hawaiian Youth

This study examines the drug resistance strategies described by Native Hawaiian youth residing in rural communities. Sixty-four youth from 7 middle and intermediate schools on the Island of Hawai‘i participated in a series of gender-specific focus groups. Youth responded to 15 drug-related problem situations developed and validated from prior research. A total of 509 responses reflecting primary or secondary drug resistance strategies were identified by the youth, which were qualitatively collapsed into 16 different categories. Primary drug resistance strategies were those that participants listed as a single response, or the first part of a two-part response, while secondary drug resistance strategies were those that were used in tandem with primary drug resistance strategies. Over half of the responses reflecting primary drug resistance strategies fell into three different categories (“refuse,” “explain,” or “angry refusal”), whereas over half of the responses reflecting secondary drug resistance strategies represented one category (“explain”). Significant gender differences were found in the frequency of using different strategies as well as variations in the frequency of using different strategies based on the type of drug offerer (family versus friends/peers). Implications for prevention practice are discussed.