Development and Implementation of a Culturally Centered Opioid Prevention Intervention for American Indian/Alaska Native Young Adults in California

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PROJECT SUMMARY/ABSTRACT American Indian/Alaska Native (AI/AN) people are disproportionately affected by the opioid epidemic. They have the highest rates of diagnosis for opioid use disorders (OUD) and deaths from drug overdose. The COVID- 19 pandemic dramatically changed how health interventions are delivered within the healthcare setting, and we had to change our new opioid use prevention intervention for urban AI/AN emerging adults to virtual at the beginning of the pandemic. Although we have been successful in recruiting individuals from 28 states into our study and having these individuals complete surveys, we have encountered challenges with retention in the online workshops as the pandemic has progressed. As COVID-19 rates began to decrease, our emerging adult population began to re-engage more with recreational, social, education, and employment activities, and participation and retention in the workshops decreased. We thus pivoted once again to increase both feasibility and deliverability of Traditions and Connections for Urban Native Americans (TACUNA) by decreasing our workshops to 1-hour, recognizing realities of zoom fatigue and the busy and active lifestyles of our study population. The aims of this supplement are within scope of the parent grant, yet expand the grant by providing us with a unique opportunity to analyze and compare benefits of deliverability of the virtual 1-hour workshops with our originally planned 2-hour workshops. We have 158 participants who were assigned to the 2-hour TACUNA program. This supplement will allow us to obtain an additional 50 participants for the 1-hour TACUNA program, so we can obtain a total N= 75 in this new condition. Aim 1. Assess differences between the virtual 1-hour version of TACUNA and the 2-hour version of TACUNA on the main outcomes of the parent grant at 3-, 6- and 12-months: initiation and escalation of opioid use and alcohol and other drug use, such as marijuana, and related consequences; time spent around peers who use opioids and alcohol and other drugs, and perceived prevalence of peer use. Aim 2. Examine whether overall participation and retention differs between the virtual 1-hour TACUNA and 2-hour TACUNA. Aim 3. Examine whether there are differences on both quantitative and qualitative satisfaction between the virtual 1-hour TACUNA and 2-hour TACUNA using a mixed methods analysis. This is the first study to evaluate effects of procedural changes that had to be made due to the COVID-19 pandemic, specifically by comparing opioid, alcohol and cannabis outcomes for urban AI/AN emerging adults who receive 1-hour virtual TACUNA workshops compared to those who receive 2-hour workshops. There is great potential to demonstrate how TACUNA can meet the needs of the tribally-diverse and heterogeneous population of AI/AN emerging adults residing in urban and other non-reservation areas throughout the U.S. This study will also provide critical information on how participants view the two versions of these virtual workshops using a mixed methods approach.