Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY)
Condition: Alcohol Use; Marijuana Use
MeSH terms: Alcohol Drinking; Marijuana Use
Study type: Interventional

Summary: 
      The investigators plan to develop and test a new alcohol and other drug (AOD) intervention
      for urban AI/AN youth, "Motivational Interviewing and Culture for Urban Native American Youth
      (MICUNAY)." This intervention integrates tradition-based activities and motivational
      interviewing (MI). The investigators will intervene at both the community and individual
      level. At the individual level, they will provide MICUNAY to adolescents. At the community
      level, they will provide discussion of AOD prevention at Community Wellness Gatherings (CWG).
      This work is important because they will gain an understanding of how well a tradition-based
      healing program that integrates MI works to prevent AOD use among urban AI/AN youth.
    

Detailed description: 
      American Indian/Alaska Native (AI/AN) youth report higher rates of alcohol and drug (AOD)
      use, greater frequency and intensity of AOD use, earlier first AOD use, and much higher
      alcohol-related mortality than other racial/ethnic groups in the U.S. Data regarding urban
      AIs/ANs are limited; however, one study found that at-risk AIs/AN adults in an urban setting
      report an earlier onset of alcohol, marijuana, methamphetamine, and other drug use compared
      to all other ethnic/racial groups within LA County. This proposal responds to PAR-11-346,
      Interventions for Health Promotion and Disease Prevention in Native American Populations,
      which is focused on developing, adapting, and testing the effectiveness of health promotion
      prevention interventions in Native American populations. The two co-PI's provide a unique
      blend of expertise that has resulted in the development of an innovative preliminary protocol
      for AI/AN youth: Motivational Interviewing and Culture for Urban Native American Youth
      (MICUNAY), which integrates traditional healing approaches with motivational interviewing
      (MI). Dickerson is an Alaska Native (Inupiaq) new investigator who worked with the AI/AN
      community to obtain community-based perspectives on decreasing AOD use and mental health
      problems. D'Amico is internationally recognized for her work focused on the development and
      testing of MI interventions targeting AOD use for culturally diverse adolescents across
      different settings. Dickerson and colleagues have demonstrated the need for
      culturally-appropriate interventions for AI/AN youth. His two community-based projects found
      that there is a lack of programs integrating tradition-based healing with evidenced based
      treatments (EBTs), and this was cited as a significant barrier to seeking care within urban
      AI/AN populations. Therefore, MICUNAY will integrate tradition-based healing with MI. It
      consists of 6 weekly 1-hour sessions (3 MI AOD sessions and 3 tradition activity sessions).
      This proposal also incorporates a multi-system intervention approach. At the individual
      level, the investigators will provide MICUNAY to urban AI/AN youth. At the community level,
      they will discuss AOD use and AOD prevention among AI/AN youth at existing Community Wellness
      Gatherings (CWG). The proposed 5-year study will consist of two main components: 1) A
      Developmental Phase in which they conduct focus groups across two clinical sites in Los
      Angeles and Oakland with the community to establish feasibility and sustainability of
      delivery, 2) A randomized controlled trial comparing youth who only attend a CWG (n=100) to
      youth who attend a CWG plus receive MICUNAY (n=100). The investigators will compare outcomes
      at 3- and 6-month follow-up to determine (a) whether clinically significant changes in AOD
      expectancies, perceived prevalence of peer AOD use, alcohol consumption, marijuana and other
      drug use, and related consequences occur; (b) whether clinically significant changes in
      physical, social, emotional, and functional well-being as well as spirituality and cultural
      identification occur, and (c) if reductions occur, estimate effect sizes for the CWG group
      and the CWG plus MICUNAY group. This study substantially extends work with AI/AN youth by
      intervening at both the community and individual level, and developing and testing an
      integrated tradition-based AOD MI group intervention for urban AI/AN youth.
    

Intervention name(s): MICUNAY; Community Wellness Gathering
Intervention type(s): Behavioral; Other
Intervention description(s): MICUNAY is a three session workshop focused on discussions about how to make healthy choices using motivational interviewing, and providing a cultural activity.; a monthly gathering focused on making healthy choices and learning about Native American culture
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: adolescents; Native American; alcohol use; drug use; cultural; traditional activities; cultural identification