ArticlePDF Available

Community Collaboration in Developing a Culturally Relevant Alcohol Abuse Early Intervention Program for First Nation Youth

Authors:

Abstract

his paper details how researchers and community partners have combined results from quantitative and qualitative investigations to develop a program for preventing alcohol abuse in First Nation at-risk teens that are meaningful to the lives of these youth. This article focuses on the levels of theory and evidence which support the development of youth interventions. While this novel, innovative program attempts to nurture health and healing practices, work needs to be done at a level not often considered by academics: the "root" level or where you meet the client to be served before the level of crisis, considering youth development as an opportunity to support a healthy growth pathway. A metaphor can help convey the associated underlying meaning. Imagine a young person, with an inclination toward alcohol abuse, standing at the edge of a cliff. Interveners tend to grab the individual at the edge, if possible. In contrast, work at the "root" level considers youth who may be a mile away from that edge of the cliff. The "root" level is a grounding level that encourages activities which speak to the creative Spirit. For example, arts, crafts, and puppetry can provide a re-vitalization of self-esteem important to achieving a sense of belonging and making a difference in one's life. Some First Nation youth may lack a sense of identification or belonging. Root re-vitalization ultimately cultivates in First Nation young people a sense of pride in their own history, their own language and in themselves. The underlying assumption behind this research is that inclination toward alcohol abuse among First Nation youth can ultimately be reduced. The purpose of this project is to learn more about the drinking behaviour of First Nation youth at high personality risk of alcohol abuse. Central features of this article include project aims and background of what this research is trying to achieve. Focus group activities, whereby a small number of youth provide their feedback and opinions about the issues and helpful processes, direct program facilitators and co-facilitators within the broad process of collaboration. The overall approach of this research is to work together with First Nation community partners to help prevent alcohol abuse by First Nation adolescents. In affiliation with the
A preview of the PDF is not available
... HED = heavy episodic drinking; RAPI = Rutger's Alcohol Problem Index. This chapter describes the development of, and pilot outcome data for, the "Nemi'simk, Seeing Oneself" intervention program (see Comeau, Stewart, Mushquash, et al., 2005). ...
... Acceptance of the interventions was also enhanced by the collaborative working alliance that was developed between the research team and key members of the community, in all aspects of the project (see Chapter 2; see also Comeau, Stewart, Mushquash, et al., 2005, for additional detail on the community collaboration involved in setting up and implementing this early intervention program). Furthermore, students at the four schools involved were actively engaged in setting up the interventions through such varied types of involvement as participating in the quantitative survey, contributing their own experiences to the qualitative interviews, and/or contributing to the artwork that was used in the manuals. ...
... A pilot project resulted that was entitled, "Nemi'simk, SeeingOneself", which included a novel set of student and facilitator manuals (©2004 6148042 Canada Inc., Dr. M. Nancy Comeau, Dr. Sherry H. Stewart, Dr. Patricia J. Conrod, & Javin Creative Inc.). The project sought to prevent alcohol and other substance misuse by at-risk First Nation teens -via brief school-based interventions that were deeply meaningful to the lives of these adolescents(Comeau, Stewart, Mushquash, Wojcik, Bartlett, Marshall et al., 2005). The project facilitated program delivery via trained community members as facilitators and co-facilitators. ...
... Programmes that are sensitive to the developmental needs, cultural values and attitudes of a target group are more effective and reported by adolescents to be more relevant [65,66]. Therefore, for every new implementation of the Preventure Programme, a preliminary process of developmental and cultural adaptation of intervention materials is recommended. ...
Article
Full-text available
Purpose of ReviewPersonality factors have been implicated in risk for substance use disorders through longitudinal and neurobiologic studies for over four decades. Only recently, however, have targeted interventions been developed to assist individuals with personality risk factors for substance use disorders manage their risk. This article reviews current practices in personality-targeted interventions and the eight randomised trials examining the efficacy of such approaches with respect to reducing and preventing substance use and misuse. Recent FindingsResults indicate a moderate mean effect size for personality-targeted approaches across several different substance use outcomes and intervention settings and formats. Conclusions Personality-targeted interventions offer several advantages over traditional substance use interventions, particularly when attempting to prevent development of problems in high-risk individuals or when addressing concurrent mental health problems in brief interventions.
... [38][39][40] The UK-based Preventure program has previously been modified for youth in the Netherlands and First Nation youth in Canada. 41,42 Feedback from key populations such as students, teachers and health professionals in Australia would enable the collation of relevant information on content, language, graphics and scenarios that would assist in making the program more up-to-date and more culturally relevant. Thus, the aim of the present study is to analyse information gleaned from focus groups in order to adapt the Preventure for Australian adolescents UK version of the Preventure program manuals for use with Australian adolescents. ...
Article
Substance use among adolescents is of significant concern and the need for preventive interventions is clear. Although universal prevention programs have shown to reduce substance use among Australian adolescents, no effective selective program has been developed for high-risk youth in Australia. Preventure is a personality-targeted intervention that has shown to be effective in the UK and Canada and is yet to be trialled in Australia. Before doing so, it is necessary to ensure the content is relevant for the Australian setting. This study reports data collected to update and adapt the UK-based Preventure program for use in Australia. Eight focus groups were conducted with 69 students from three secondary schools in Sydney, Australia. Students who screened high risk for early-onset substance misuse were invited to participate in focus groups specific to their personality profile and provide feedback. Written feedback was also obtained from 12 teachers and health professionals. Students, teachers and experts recommended specific changes to the content, language, scenarios and graphics of the Preventure manuals. The majority of teachers and experts believed that the educational content of the program was appropriate for students and that it would be effective in reducing substance use in this population. The information obtained in the current study was used to update the Preventure program for use with Australian adolescents. It is expected that this modified Preventure program will demonstrate similar effects in reducing alcohol and drug use among high-risk youth in Australia, as it did in the UK and Canada.
... Integrative science is defined as "bringing together Indigenous and Western scientific knowledge and ways of knowing". It uses pioneering, praxis-based research follow-ing integrative, action and participatory methodologies within a co-learning journey with, by, and for Aboriginal peoples and communities (Bartlett, 2005;Bartlett et al., 2010;Comeau et al., 2005;Hatcher et al., 2009;Iwama et al., in press). It was conceived in the mid-1990s in collaboration with key Mi'kmaq individuals to bring radical innovation into the educational system to begin to address the shocking underparticipation by Aboriginal young people in university science programmes and thus also in careers that require such an education. ...
Article
Full-text available
This article shares some of the experiences of an integrative science team based at Cape Breton University, Canada. Integrative science is defined as "bringing together Indigenous and Western scientific knowledge and ways of knowing" and the team includes Mi'kmaq Elders and educators, Cheryl Bartlett and her Research Associates. Together we worked to rekindle the Mi'kmaq Sky Story, Muin and the Seven Hunters, to produce a DVD of the story as well as a children's book, and then to share it with people throughout Canada and the world. We offer insights into the manner in which night sky stories engender interconnectiveness and interdependability through their cultural, scientific and ecological teachings and so help to revitalise the culture and the individual by feeding all aspects of the human experience (spiritual, emotional, physical and cognitional). We explore the concept of storywork, with emphasis on the relationship between storyteller and listener as a story is told, as well as considering the multi-layered aspect of Indigenous stories.
... An intervention program (described in detail elsewhere) developed in collaboration with First Nations school-based partners and students, was implemented in two Aboriginal communities in Atlantic Canada (Comeau et al., 2005; Mushquash, Comeau, & Stewart, 2007). This program sought to prevent alcohol misuse by Aboriginal adolescents at risk for alcohol abuse, using a risk-reduction approach. ...
Article
Full-text available
The factor structure of the Drinking Motives Questionnaire - Revised (DMQ-R; Cooper, 1994) was examined in a sample of First Nations (i.e., Mi'kmaq) adolescents. Exploratory principal components analysis indicated a three-factor structure (conformity, coping, and positive reinforcement motives), with the positive reinforcement motives of enhancement and social motives not separating into the expected two distinct factors. Moreover, community informants (e.g., school personnel) anecdotally indicated possible wording problems with some of the social motive items for the cultural group. A qualitative methodology - focus group interviews with Mi'kmaq adolescents - was used to explore potential reasons for these observed differences in the structure of drinking motives from previous findings in the majority culture (i.e., a measurement problem vs. a real difference in the structure of drinking motives in the Mi'kmaq culture). Qualitative findings support the interpretation that a true social motive for alcohol use does not exist in this cultural/age group and that drinking in social contexts for this group seems less motivated by social affiliation than by enhancement motives (e.g., drinking to party).
Article
Full-text available
Colonization of Aboriginal peoples has created serious challenges for indi-viduals and communities, particularly with regard to issues of independ-ence and control. Currently there is a pressing need to address these issues, on both the individual and group (or collective) levels. Research in the gen-eral population highlights the role of perceived personal control in well-being, and hints at a similar role for perceived collective control. The present research investigated the impact of perceived collective control on the well-being of Aboriginal youth. Residents of two Cree communities in north-ern Manitoba collaborated in the research. Together we developed two surveys on youth well-being, completed by students in grades 7 and up. The results of each study indicated that greater perceived individual inter-1. Note: This research was conducted in conjunction with two First Nations (Cree) communities in northern Manitoba. Community representatives played an integral role in developing and carrying out the research. However, the communities are not identified in this article to protect their privacy. Acknowledgements: This research was generously supported by a doctoral award to the first author from the Canadian Institutes of Health Research, Institute of Aboriginal People's Health (CIHR IAPH), and project support from the National Network for Aboriginal Mental Health Research (NNAMHR), Social Sciences and Humanities Research Council (SSHRC), and Fonds Québécois de la Recherche sur la Société et la Culture (FQRSC). Valued comments on a previous version of this article were provided by Barbel Knauper. Very special thanks to the members of the two participating communities, in particular the youth. Meegwetch.
Article
Full-text available
This paper details a four-stage methodology for developing early alcohol interventions for at-risk Aboriginal youth. Stage 1 was an integrative approach to Aboriginal education that upholds Aboriginal traditional wisdom supporting respectful relationships to the Creator, to the land and to each other. Stage 2 used quantitative methods to investigate associations between personality risk factors and risky drinking motives. Stage 3 used qualitative interviews to further understand the contexts and circumstances surrounding drinking behaviour within a larger cultural context. Stage 3 involved tailoring personality-matched, motive-specific brief interventions to meet at-risk adolescents’ needs. Stage 4 involved an efficacy test of the interventions. This novel methodology has significance for future program development to meet diverse social, cultural and health needs of at-risk adolescents. KeywordsDrinking motives-Aboriginal adolescents-Early intervention-Personality risk-Alcohol abuse
Article
Full-text available
Several large-scale studies examining outcome predictors across various substance use treatments indicate a need to focus on psychiatric comorbidity as a very important predictor of poorer SUD treatment involvement and outcome. We have previously argued that current cognitive-behavioral treatments (CBT) approaches to SUD treatment do not focus on the necessary content in treatment in order to effectively address specific forms of psychiatric comorbidity, and thus only provide clients with generic coping strategies for managing psychiatric illness (as would be achieved in other SUD treatment approaches; Conrod et al., 2000). Furthermore, following our review of the literature on dual-focused CBT treatment programs for concurrent disorders in this article, we argue that combining CBT-oriented SUD treatments with specific CBT treatments for psychiatric disorders is not as straightforward as one would think. Rather, it requires very careful consideration of the functional relationship between specific disorders, patient reactions to specific treatment components, and certain barriers to treatment in order to achieve an integrated dual-diagnosis focus in treatment that is meaningful and to which clients can adhere.
Article
Full-text available
The cross-cultural program of research presented here is about matters of temporal persistence--personal persistence and cultural persistence--and about solution strategies for solving the paradox of "sameness-in-change." The crux of this paradox resides in the fact that, on threat of otherwise ceasing to be recognizable as a self, all of us must satisfy at least two constitutive conditions. The first of these is that selves are obliged to keep moving or die, and, so, must continually change. The second is that selves must also somehow remain the same, lest all notions of moral responsibility and any commitment to an as yet unrealized future become nonsensical. Although long understood as a problem demanding the attention of philosophers, we argue that this same paradox arises in the ordinary course of identity development and dictates the different developmental routes taken by culturally mainstream and Aboriginal youth in coming to the identity-preserving conclusion that they and others are somehow continuous through time. Findings from a set of five studies are presented. The first and second studies document the development and refinement of a method for parsing and coding what young people say on the topic of personal persistence or self-continuity. Both studies demonstrate that it is not only possible to seriously engage children as young as age 9 or 10 years in detailed and codable discussions about personal persistence, but that their reasoning concerning such matters typically proceeds in an orderly and increasingly sophisticated manner over the course of their early identity development. Our third study underscores the high personal costs of failing to sustain a workable sense of personal persistence by showing that failures to warrant self-continuity are strongly associated with increased suicide risk in adolescence. Study four documents this same relation between continuity and suicide, this time at the macrolevel of whole cultures, and shows that efforts by Aboriginal groups to preserve and promote their culture are associated with dramatic reductions in rates of youth suicide. In the final study we show that different default strategies for resolving the paradox of personal persistence and change--Narrative and Essentialist strategies--distinctly characterize Aboriginal and non-Aboriginal youth.
A novel methodology for the development of adolescent alcohol abuse preventative interventions
  • M N Comeau
  • S Stewart
  • H Loba
  • P Theakston
Comeau, M. N., Stewart, S., H., Loba, P., & Theakston, J. (2004). A novel methodology for the development of adolescent alcohol abuse preventative interventions. Alcoholism: Clinical and Experimental Research, 28 (Suppl. 5), 179A