Clinical trial NCT02290938: Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY)
Official title: Motivational Interviewing and Culture for Urban Native American Youth (MICUNAY)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Alcohol Use
Marijuana Use
Keywords: adolescents
Native American
alcohol use
drug use
cultural
traditional activities
cultural identification
Lead sponsor: RAND
Sponsor class: OTHER
Collaborators: name: National Institute on Alcohol Abuse and Alcoholism (NIAAA)
name: National Institute on Drug Abuse (NIDA)
name: University of California, Los Angeles
name: Sacred Path Indigenous Wellness Center
First posted: 2014-11-14
Enrollment: 185
Sex: ALL
Minimum age (years): 14
Maximum age (years): 18
Standard ages: CHILD
ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: PREVENTION

Brief 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.

Eligibility criteria: Inclusion Criteria:

* identify as Native American
* age 14-18

Exclusion Criteria:

* just need to meet inclusion criteria

Primary outcomes:
measure: Number of Participants Who Used Alcohol From Baseline to 6 Months
timeFrame: change from baseline to 6 months
measure: Number of Participants Who Used Marijuana From Baseline to 6 Months
timeFrame: change from baseline to 6 months
Secondary outcomes:
measure: Number of Participants Who Reported Consequences of Alcohol Use
timeFrame: change from baseline to 6 months
measure: Number of Participants Who Reported Consequences of Marijuana Use
timeFrame: change from baseline to 6 months
measure: Change in Intentions to Use - Alcohol
timeFrame: change from baseline to 6 months
measure: Change in Intentions to Use - Cigarettes
timeFrame: change from baseline to 6 months
measure: Change in Intentions to Use - Marijuana
timeFrame: change from baseline to 6 months
measure: Change in Alcohol Resistance Self-efficacy
timeFrame: change from baseline to 6 months
measure: Change in Peer Influence - Alcohol
timeFrame: change from baseline to 6 months
measure: Change in Peer Influence - Marijuana
timeFrame: change from baseline to 6 months
measure: Change in Peer Influence - Cigarettes
timeFrame: change from baseline to 6 months
measure: Change in Intentions to Participate in Traditional Practices
timeFrame: change from baseline to 6 months
measure: Change in Cultural Identification
timeFrame: change from baseline to 6 months
measure: Change in Spirituality/Happiness
timeFrame: change from baseline to 6 months
Other outcomes:
Locations:
city: Los Angeles
country: United States
facility: United American Indian Involvement, Inc
state: California
city: Oakland
country: United States
facility: American Indian Child Resource Center
state: California
Study officials:
affiliation: RAND
name: Elizabeth D'Amico, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: University of California, Los Angeles
name: Daniel Dickerson, D.O., M.P.H
role: PRINCIPAL_INVESTIGATOR
References:
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citation: D'Amico EJ, Miles JN, Stern SA, Meredith LS. Brief motivational interviewing for teens at risk of substance use consequences: a randomized pilot study in a primary care clinic. J Subst Abuse Treat. 2008 Jul;35(1):53-61. doi: 10.1016/j.jsat.2007.08.008. Epub 2007 Nov 26.
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citation: Brown RA, Dickerson DL, D'Amico EJ. Cultural Identity Among Urban American Indian/Alaska Native Youth: Implications for Alcohol and Drug Use. Prev Sci. 2016 Oct;17(7):852-61. doi: 10.1007/s11121-016-0680-1.
citation: Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D. Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy--Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med. 2002 Winter;24(1):49-58. doi: 10.1207/S15324796ABM2401_06.
citation: Dickerson DL, Parker J, Johnson CL, Brown RA, D'Amico EJ. Recruitment and retention in randomized controlled trials with urban American Indian/Alaska Native adolescents: Challenges and lessons learned. Clin Trials. 2021 Feb;18(1):83-91. doi: 10.1177/1740774520971774. Epub 2020 Nov 24.