Family Listening Program: Multi-Tribal Implementation and Evaluation
Condition: Substance Abuse
MeSH terms: Substance-Related Disorders
Study type: Interventional

Summary: 
      This is a five-year R01 effectiveness trial where tribal partners are committed to assessing
      the Family Listening/Circle Program's effectiveness and disseminating the approach and
      intervention within Indian Country as a best practice in reducing substance abuse health
      disparities.Three specific aims of the grant are 1) To rigorously test effectiveness of FLCP;
      with a comparative longitudinal design within and across the tribes, with 4th graders to
      prevent substance initiation/use and strengthen families; 2) Through CBPR, support TRTs to
      transform their research capacities into local prevention research infrastructures and
      partnering; 3)To assess additional program effects on other health/education programs and
      leadership within the tribes. In sum, this multi-tribal/academic partnership builds on
      accomplishments to test the effectiveness of an innovative intervention. This grant provides
      an unparalleled opportunity to reduce substance abuse in three tribal communities, strengthen
      tribal research capacities, and impact substance abuse prevention research designs
      nationally, by illustrating how CBPR processes can integrate evidence-based and
      cultural-centered practices to create effective programs that generate community ownership
      and sustainability.
    

Detailed description: 
      With substance abuse concerns plaguing tribal communities, health preventive approaches for
      American Indian (AI) children need urgent attention. Mainstream programs fall short by
      failing to speak to AI children on their own terms. Not so with the Family Listening/Circle
      Program (FL/CP) which integrates an evidence-based family-strengthening core, with cultural
      values and practices for 4th graders, their parents and elders. Through previous Native
      American Research Centers for Health funding (Indian Health Service & National Institutes of
      Health partnership) the FL/CP was created and piloted by community-based participatory
      research (CBPR) partnerships between the University of New Mexico Center for Participatory
      Research and three tribal communities: Pueblo of Jemez, Ramah Band of Navajo and Mescalero
      Apache Nation. FL/CP fills a gap in substance abuse prevention by recapturing historic
      traditions of cultural transmission, such as family dinner story-telling where elders connect
      with children, supporting enhanced child-family communication and psycho-social coping
      through traditional dialogue, indigenous languages and empowerment where children and
      families create community action projects addressing community substance abuse. With initial
      FL/CP pilot and feasibility research completed, Tribal Research Teams (TRTs) from the Pueblo
      of Jemez, Ramah Band of Navajo and Mescalero Apache Nation are now in place for full program
      implementation and effectiveness testing through a longitudinal quasi-experimental design
      involving a long-term, multi-tribal/academic research partnership. Under this five-year R01
      effectiveness trial, tribal partners are committed to assessing the program's effectiveness
      and disseminating the approach and intervention within Indian Country as a best practice in
      reducing substance abuse health disparities, with TRTs collaborating on all research
      activities, implementation, interpretation/analysis, and dissemination plans. Three specific
      aims are 1) To rigorously test effectiveness of FLCP; with a comparative longitudinal design
      within and across the tribes, with 4th graders to prevent substance initiation/use and
      strengthen families; 2) Through CBPR, support TRTs to transform their research capacities
      into local prevention research infrastructures and partnering; 3)To assess additional program
      effects on other health/education programs and leadership within the tribes. In sum, this
      multi-tribal/academic partnership builds on accomplishments to test the effectiveness of an
      innovative intervention. This grant provides an unparalleled opportunity to reduce substance
      abuse in three tribal communities, strengthen tribal research capacities, and impact
      substance abuse prevention research designs nationally, by illustrating how CBPR processes
      can integrate evidence-based and cultural-centered practices to create effective programs
      that generate community ownership and sustainability.
    

Intervention name(s): Intergenerational culturally adapted curriculum
Intervention type(s): Other
Intervention description(s): Each session starts with a collective dinner with families eating together. Then practice their Indian and clan names. The sessions are led by facilitators in their own language or bilingually. The facilitators then divide the families into children and adult groups to address the theme of the session, and they then return together at the end of the session to share their learnings. The sessions always end with the children and adults writing in their journals which are individual pages that they then put in their curriculum binders. Families are then given their "home practice," which is a task that the families do together during the intervening week. The facilitators collect the curriculum binders after each session to bring back to the families the next week.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Intervention model description: The investigators use a two arm non-equivalent control group design with pretest, immediate post- test, and 12 month follow-up assessment points. Among quasi-experimental designs that could be employed, this design carries several advantages over other designs in being able to infer causality. One advantage of this design is that it allows for a more meaningful analysis of the impact of the FL/CP intervention by a comparison of the intervention group with the usual and customary comparison group, an advantage not possible with single-group over time designs. Second, the design provides an analysis of diffusion effects (i.e. the potential influence of the intervention on the comparison group over time). Given the tight social networks and small number of interconnected families in the three participating communities, the investigators expect some degree of program diffusion in the comparison group families.
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: Community-Based Participatory Research