Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Addiction Science & Clinical Practice
Published in: Addiction Science & Clinical Practice 1/2021

01-12-2021 | Opioids | Study Protocol

Integrating traditional practices and social network visualization to prevent substance use: study protocol for a randomized controlled trial among urban Native American emerging adults

Authors: Elizabeth J. D’Amico, Daniel L. Dickerson, Anthony Rodriguez, Ryan A. Brown, David P. Kennedy, Alina I. Palimaru, Carrie Johnson, Rosanna Smart, David J. Klein, Jennifer Parker, Keisha McDonald, Michael J. Woodward, Ninna Gudgell

Published in: Addiction Science & Clinical Practice | Issue 1/2021

Login to get access

Abstract

Background

Nonmedical use of prescription opioids (defined as taking opioid medications for hedonic effects or in a manner other than prescribed) and the use of heroin have emerged in recent years as major public health concerns in the United States. Of particular concern is the prevalence of opioid use among emerging adults (ages 18–25), as this is a developmental period of heightened vulnerability and critical social, neurological, and psychological development. Data from 2015 show that American Indian/Alaska Native (AI/AN) people have the highest rates of diagnosis for opioid use disorders (OUDs). One recent study found that the overdose death rate among urban-dwelling AI/AN individuals was 1.4 times higher compared to those living in rural areas. To date, there are no evidence-based prevention programs addressing opioid use among urban AI/AN emerging adults that integrate culturally-appropriate strategies with evidence-based treatment. Traditions and Connections for Urban Native Americans (TACUNA) builds on our prior work with AI/AN communities across California to develop and evaluate culturally appropriate programming to address opioid, alcohol, and cannabis use among urban AI/AN emerging adults.

Methods/design

In a randomized controlled trial, 18–25 year old urban AI/AN emerging adults will receive either TACUNA (n = 185), which comprises three virtual workshops utilizing motivational interviewing, social network visualization, and integrating traditional practices and a wellness circle, or one virtual culturally sensitive opioid education workshop (n = 185). We will evaluate intervention effects on primary outcomes of frequency of opioid, alcohol, and cannabis use, as well as secondary outcomes of social network characteristics and cultural connectedness, over a 12-month period.

Discussion

This project has the potential to expand the range and effectiveness of opioid, alcohol, and cannabis services for urban AI/AN emerging adults by addressing the opioid epidemic and use of other substances at both the community and individual level. In addition, it provides important culturally grounded conceptual and practical information to advance the field of substance use interventions and enhance resiliency among this population.
Trial registration: ClinicalTrials.gov Identifier: NCT04617938. Registered October 26, 2020 https://​clinicaltrials.​gov/​ct2/​show/​record/​NCT04617938.
Appendix
Available only for authorised users
Literature
1.
2.
Venner KL, Donovan DM, Campbell ANC, Wendt DC, Rieckmann T, Radin SM, et al. Future directions for medication assisted treatment for opioid use disorder with American Indian/Alaska Natives. Addict Behav. 2018;86:111–7.PubMedPubMedCentralCrossRef
3.
Tipps RT, Buzzard GT, McDougall JA. The opioid epidemic in Indian Country. J Law Med Ethics. 2018;46:422–36.PubMedCrossRef
4.
Center for Behavioral Health Statistics and Quality. National Survey on Drug Use and Health: Detailed Tables. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2016.
5.
Wilson N, Kariisa M, Seth P, Smith H, NLD. Drug and opioid-involved overdose deaths—United States, 2017–2018. MMWR Morb Mortal Wkly Rep 2020. p. 290–7.
6.
Joshi S, Weiser T, Warren-Mears V. Drug, opioid-involved, and heroin-involved overdose deaths among American Indians and Alaska Natives—Washington, 1999–2015. MMWR Morb Mortal Wkly Rep. 2018;67:1384–7.PubMedPubMedCentralCrossRef
7.
Hansen RN, Oster G, Edelsberg J, Woody GE, Sullivan SD. Economic costs of nonmedical use of prescription opioids. Clin J Pain. 2011;27(3):194–202.PubMedCrossRef
8.
Birnbaum HG, White AG, Schiller M, Waldman T, Cleveland JM, Roland CL. Societal costs of prescription opioid abuse, dependence, and misuse in the United States. Pain Med. 2011;12(4):657–67.PubMedCrossRef
9.
Cobb N, Espey D, King J. Health behaviors and risk factors among American Indians and Alaska Natives, 2000–2010. Am J Public Health. 2014;104:S481–9.PubMedPubMedCentralCrossRef
10.
Arias E, Xu J, Jim MA. Period life tables for the non-Hispanic American Indian and Alaska Native population, 2007–2009. Am J Public Health. 2014;104:S312–9.PubMedPubMedCentralCrossRef
11.
Brave Heart MYH, DeBruyn LM. The American Indian holocaust: healing historical unresolved grief. Am Indian Alaska Native Mental Health Res. 1998;8(2):56–78.
12.
Duran E, Duran B. Native American post-colonial psychology. New York, NY: Suny Press; 1995.
13.
Burt LW. Roots of the Native American urban experience: relocation policy in the 1950s. Am Indian Q. 1986;10(2):85–99.CrossRef
14.
Myhra LL. “It runs in the family”: Intergenerational transmission of historical trauma among urban American Indians and Alaska Natives in culturally specific sobriety maintenance programs. Am Indian Alaska Native Mental Health Res. 2011;18(2):17–40.CrossRef
15.
Myhra LL, Wieling E. Intergenerational patterns of substance abuse among urban American Indian families. J Ethn Subst Abuse. 2014;13(1):1–22.PubMedCrossRef
16.
Brown RA, Dickerson DL, D’Amico EJ. Cultural identity among urban American Indian/Alaska Native youth: implications for intervention design. Prev Sci. 2016;17(7):852–61.PubMedPubMedCentralCrossRef
17.
Brown RA, Dickerson DL, Klein DJ, Agniel D, Johnson C, D’Amico EJ. Identifying as American Indian/Alaska Native: implications for adolescent behavioral health and well-being. Youth & Society (in press).
18.
Dickerson DL, Brown RA, Klein DJ, Agniel D, Johnson C, D’Amico EJ. Discrimination and its association with health risk behaviors among a sample of urban American Indian/Alaska Native adolescents. J Racial Ethnic Health Disparities (in press).
19.
Jones ML, Galliher RV. Daily racial microaggressions and ethnic identification among Native American young adults. Cultur Divers Ethnic Minor Psychol. 2015;21(1):1–9.PubMedCrossRef
20.
Kennedy DP, Osilla KC, Hunter SB, Golinelli D, Maksabedian Hernandez E, Tucker JS. A pilot test of a motivational interviewing social network intervention to reduce substance use among housing first residents. J Subst Abuse Treat. 2018;86:36–44.PubMedCrossRef
21.
Tobler AL, Maldonado-Molina MM, Staras SAS, O’Mara RJ, Livingston MD, Komro KA. Perceived racial/ethnic discrimination, problem behaviors, and mental health among minority urban youth. Ethn Health. 2013;18(4):337–49.PubMedCrossRef
22.
Brodish AB, Cogburn CD, Fuller-Rowell TE, Peck S, Malanchuk O, Eccles JS. Perceived racial discrimination as a predictor of health behaviors: the moderating role of gender. Race Soc Probl. 2011;3(3):160–9.PubMedPubMedCentralCrossRef
23.
24.
25.
26.
Crump AD, Etz K, Arroyo JA, Hemberger N, Srinivasan S. Accelerating and strengthening Native American health research through a collaborative NIH initiative. Prev Sci. 2020;21:1–4.PubMedCrossRef
27.
28.
29.
30.
31.
32.
33.
D’Amico EJ, Dickerson DL. Development and implementation of a culturally centered opioid prevention intervention for American Indian/Alaska Native young adults in California. National Institute on Drug Abuse; 2020.
34.
D’Amico EJ, Dickerson DL, Brown RA, Johnson C, Agniel D, Klein D. Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY): a randomized controlled trial. J Subst Abuse Treat. 2020;111:86–99.PubMedCrossRef
35.
Berwick DM. Disseminating innovations in health care. JAMA J Am Med Assoc. 2003;289(15):1969–75.CrossRef
36.
Sanson-Fisher RW, Campbell EM, Perkins JJ, Blunden S, Davis B. Indigenous health research: a critical review of outputs over time. Med J Aust. 2006;184:502–5.PubMedCrossRef
37.
Legha RK, Novins D. The role of culture in substance abuse treatment programs for American Indian and Alaska Native communities. Psychiatr Serv. 2012;63(7):686–92.PubMedCrossRef
38.
Gone JP, Looking PE. American Indian culture as substance abuse treatment: pursuing evidence for a local intervention. J Psychoactive Drugs. 2011;43(4):291–6.PubMedCrossRef
39.
Wright S, Nebelkopf E, King J, Maas M, Patel C, Samuel S. Holistic system of care: evidence of effectiveness. Subst Use Misuse. 2011;46(11):1420–30.PubMedCrossRef
40.
Hanson KL, Lisdahl Medina K, Padula CB, Tapert SF, Brown SA. Impact of adolescent alcohol and drug use on neuropsychological functioning in young adulthood:10-year outcomes. J Child Adolesc Subst Abuse. 2011;20(2):135–54.PubMedPubMedCentralCrossRef
41.
United Nations Office on Drugs and Crime. World drug report. Vienna, Austria: United Nations; 2014.
42.
Dickerson DL, Brown RA, Johnson CL, Schweigman K, D’Amico EJ. Integrating motivational interviewing and traditional practices to address alcohol and drug use among urban American Indian/Alaska Native youth. J Subst Abuse Treat. 2015;65:26–35.PubMedPubMedCentralCrossRef
43.
Kennedy DP, Hunter SB, Osilla KC, Maksabedian E, Golinelli D, Tucker JS. A computer-assisted motivational social network intervention to reduce alcohol, drug and HIV risk behaviors among housing first residents. Addict Sci Clin Pract. 2016;11(1):1–13.CrossRef
44.
Osilla KC, Kennedy DP, Hunter SB, Maksabedian E. Feasibility of a computer-assisted social network motivational interviewing intervention for substance use and HIV risk behaviors for housing first residents. Addict Sci Clin Pract. 2016;11(14):1–11.
45.
46.
D’Amico EJ, Parast L, Shadel WG, Meredith LS, Seelam R, Stein BD. Brief motivational interviewing intervention to reduce alcohol and marijuana use for at-risk adolescents in primary care: a randomized clinical trial. J Consult Clin Psychol. 2018;86(9):775–86.PubMedPubMedCentralCrossRef
47.
D’Amico EJ, Tucker JS, Miles JNV, Zhou AJ, Shih RA, Green HDJ. Preventing alcohol use with a voluntary after school program for middle school students: results from a cluster randomized controlled trial of CHOICE. Prev Sci. 2012;13(4):415–25.PubMedPubMedCentralCrossRef
48.
49.
Warne D. The Medicine Wheel, 1 of 3 (video). 2007.
50.
Warne D. The Medicine Wheel, 2 of 3 (video). 2007.
51.
Warne D. The Medicine Wheel, 3 of 3 (video). 2007.
52.
D’Amico EJ, Hunter SB, Miles JNV, Ewing BA, Osilla KC. A randomized controlled trial of a group motivational interviewing intervention for adolescents with a first time alcohol or drug offense. J Subst Abuse Treat. 2013;45(5):400–8.PubMedCrossRef
53.
54.
Wickersham JA, Azar MM, Cannon CM, Altice FL, Springer SA. Validation of a brief measure of opioid dependence: the rapid opioid dependence screen (RODS). J Correct Health Care. 2015;21(1):12–26.PubMedCrossRef
55.
Johnston LD, O'Malley PM, Bachman JG, Schulenberg JE. Monitoring the Future national survey results on drug use, 1975–2010. Volume I: Secondary school students. Ann Arbor, Michigan: Institute for Social Research, The University of Michigan; 2011.
56.
Johnston LD, O’Malley PM. Issues of validity and population coverage in student surveys of drug use. In: Rouse BA, Casual NJ, Richards LG, editors. Self-report methods of estimating drug use: Meeting current challenges to validity. NIDA research Monograph 57. Rockville, MD: NIDA; 1985.
57.
Johnston LD, O’Malley PM, Bachman JG. National survey results on drug use from the Monitoring the Future Study, 1975–1997. Bethesda, MD: National Institute on Drug Abuse; 1998.
58.
Johnston LD, O'Malley PM. The recanting of earlier-reported drug use by young adults. In: Harrison L, Hughes A, editors. The validity of self-reported drug use: Improving the accuracy of survey estimates. NIDA research monograph 167. Washington D.D.: NIDA; 1997. pp. 59–80.
59.
Snowshoe A, Crooks CV, Tremblay PF, Craig WM, Hinson RE. Development of a cultural connectedness scale for First Nations youth. Psychol Assess. 2015;27(1):249–59.PubMedCrossRef
60.
Perry BL, Pescosolido BA, Borgatti SP. Egocentric network analysis: foundations, methods, and models. Cambridge, UK: Cambridge University Press; 2018.CrossRef
61.
Crossley N, Bellotti E, Edwards G, Everett MG, Koskinen J, Tranmer M. Social network analysis for ego-nets: social network analysis for actor-centred networks: SAGE; 2015.
62.
Kennedy DP, Wenzel SL, Tucker JS, Green HD Jr, Golinelli D, Ryan GW, et al. Unprotected sex of homeless women living in Los Angeles County: an investigation of the multiple levels of risk. AIDS Behav. 2010;14(4):960–73.PubMedPubMedCentralCrossRef
63.
Rhoades H, Wenzel SL, Golinelli D, Tucker JS, Kennedy DP, Green HD, et al. The social context of homeless men’s substance use. Drug Alcohol Depend. 2011;118(2/3):320–5.PubMedPubMedCentralCrossRef
64.
Golinelli D, Ryan G, Green HD Jr, Kennedy DP, Tucker JS, Wenzel SL. Sampling to reduce respondent burden in personal network studies and its effect on estimates of structural measures. Field Methods. 2010;22(3):217–30.PubMedPubMedCentralCrossRef
65.
McCarty C, Killworth PD, Rennell J. Impact of methods for reducing respondent burden on personal network structural measures. Social Netw. 2007;29(2):217–30.CrossRef
66.
Tucker JS, Kennedy D, Ryan G, Wenzel SL, Golinelli D, Zazzali J. Homeless women’s personal networks: implications for understanding risk behavior. Hum Organ. 2009;68(2):129–40.PubMedPubMedCentralCrossRef
67.
McCarty C. Measuring structure in personal networks. Gainesville, FL: University of Florida; 2002.
68.
Borgatti SP, Everett MG, Johnson JC. Analyzing social networks. 2nd edn. SAGE Publications Limited; 2018.
69.
Sanders GD, Neumann PJ, Basu A, Brock DW, Feeny D, Krahn M, et al. Recommendations for conduct, methodological practices, and reporting of cost-effectiveness analyses: second panel on cost-effectiveness in health and medicine. JAMA J Am Med Assoc. 2016;316(10):1093–103.CrossRef
70.
Kilmer B, Burgdorf J, D’Amico EJ, Tucker JS, Miles JNV. A multi-site cost analysis of a school-based voluntary alcohol and drug prevention program. J Stud Alcohol Drugs. 2011;72(5):823–32.PubMedPubMedCentralCrossRef
71.
Zarkin GA, Bray JW, Davis KL, Babor TF, Higgins-Biddle JC. The costs of screening and brief intervention for risky alcohol use. J Stud Alcohol. 2003;64:849–57.PubMedCrossRef
72.
Murphy SM, Campbell ANC, Ghitza UE, Kyle TL, Bailey GL, Nunes EV, et al. Cost-effectiveness of an internet-delivered treatment for substance abuse: data from a multisite randomized controlled trial. Drug Alcohol Depend. 2016;161:119–26.PubMedPubMedCentralCrossRef
73.
Cowell AJ, Zarkin GA, Wedehase BJ, Lerch J, Walters ST, Taxman FS. Cost and cost-effectiveness of computerized vs in-person motivational interventions in the criminal justice system. J Subst Abuse Treat. 2018;87:42–9.PubMedPubMedCentralCrossRef
74.
Sindelar JL, Jofre-Bonet M, French MT, McLellan AT. Cost-effectiveness analysis of addiction treatment: paradoxes of multiple outcomes. Drug Alcohol Depend. 2004;73(1):41–50.PubMedCrossRef
75.
Cowell AJ, Bray JW, Mills MJ, Hinde JM. Conducting economic evaluations of screening and brief intervention for hazardous drinking: methods and evidence to date for informing policy. Drug Alcohol Rev. 2010;29(6):623–30.PubMedPubMedCentralCrossRef
76.
Conigliani C, Tancredi A. A bayesian model averaging approach for cost-effectiveness analyses. Health Econ. 2009;18(7):807–21.PubMedCrossRef
77.
Chaudhary MA, Stearns SC. Estimating confidence intervals for cost-effectiveness ratios: an example from a randomized trial. Stat Med. 1996;15(13):1447–58.PubMedCrossRef
78.
Polsky D. Confidence intervals for cost-effectiveness ratios: a comparison of four methods. Health Econ. 1997;6(3):243–52.PubMedCrossRef
79.
Willan AR, O’Brien BJ. Confidence intervals for cost-effectiveness ratios: an application of Fieller’s Theorem. Health Econ. 1996;5(4):297–305.PubMedCrossRef
80.
Barber JA, Thompson SG. Analysis of cost data in randomized trials: an application of the non-parametric bootstrap. Statist Med. 2000;19(23):3219.CrossRef
81.
Fenwick E, Claxton K, Sculpher M. Representing uncertainty: the role of cost-effectiveness acceptability curves. Health Econ. 2001;10(8):779–87.PubMedCrossRef
82.
Adegboye ARA, Cocate PG, Benaim C, da Veiga Soares Carvalho MC, Schlüssel MM, de Castro MBT, et al. Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial. Trials. 2020;21(1):244.CrossRef
83.
Aycinena AC, Valdovinos C, Crew KD, Tsai WY, Mata JM, Sandoval R, et al. Barriers to recruitment and adherence in a randomized controlled diet and exercise weight loss intervention among minority breast cancer survivors. J Immigr Minor Health. 2017;19(1):120–9.PubMedCrossRef
84.
D’Amico EJ, Dickerson DL, Brown RA, Klein DJ, Agniel D, Johnson C. Unveiling an ‘invisible’ population: health, substance use, sexual behavior, culture, and discrimination among urban American Indian/Alaska Native adolescents in California. Ethn Health. 2019;26(6):845–62.PubMedPubMedCentralCrossRef
85.
Dickerson DL, Brown RA, Klein DJ, Agniel D, Johnson C, D’Amico EJ. Overt perceived discrimination and racial microaggressions and their association with health risk behaviors among a sample of urban American Indian/Alaska Native adolescents. J Racial Ethn Health Disparities. 2019;6(4):733–42.PubMedPubMedCentralCrossRef
86.
Kaholokula J, Ing C, Look M, Delafield R, Sinclair K. Culturally responsive approaches to health promotion for Native Hawaiians and Pacific Islanders. Ann Hum Biol. 2018;45(3):249–53.PubMedPubMedCentralCrossRef
87.
Bassett D, Tsosie U, Nannauck S. “Our culture is medicine”: perspectives of Native healers on posttrauma recovery among American Indian and Alaska Native patients. Permanente J. 2012;16(1):19–27.CrossRef
88.
Shuman N. The use of traditional healing practices to address AI/AN historical trauma and disparities in behavioral health. Washington D.C.: National Council of Urban Indian Health; 2018.
89.
Philip J, Ford T, Henry D, Rasmus S, Allen J. Relationship of social network to protective factors in suicide and alcohol use disorder intervention for rural Yup’ik Alaska Native youth. Psychosoc Interv. 2016;25:45–54.CrossRef
Metadata
Title
Integrating traditional practices and social network visualization to prevent substance use: study protocol for a randomized controlled trial among urban Native American emerging adults
Authors
Elizabeth J. D’Amico
Daniel L. Dickerson
Anthony Rodriguez
Ryan A. Brown
David P. Kennedy
Alina I. Palimaru
Carrie Johnson
Rosanna Smart
David J. Klein
Jennifer Parker
Keisha McDonald
Michael J. Woodward
Ninna Gudgell
Publication date
01-12-2021
Publisher
BioMed Central
Keywords
Opioids
Opioids
Published in
Addiction Science & Clinical Practice / Issue 1/2021
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/s13722-021-00265-3

Other articles of this Issue 1/2021

Addiction Science & Clinical Practice 1/2021 Go to the issue

Research

Perceived family cohesion, social support, and quality of life in patients undergoing treatment for substance use disorders compared with patients with mental and physical disorders

Study Protocol

Implementation facilitation to introduce and support emergency department-initiated buprenorphine for opioid use disorder in high need, low resource settings: protocol for multi-site implementation-feasibility study

Research

Effects of morbidity on smoking cessation: a national smoking cessation program

Research

Clinical leaders and providers’ perspectives on delivering medications for the treatment of opioid use disorder in Veteran Affairs’ facilities

Research

Should screening for risk of gambling-related harm be undertaken in health, care and support settings? A systematic review of the international evidence

Research

‘Treat my whole person, not just my condition’: qualitative explorations of hepatitis C care delivery preferences among people who inject drugs