Assessing Cultures of Recovery in Tribal Communities - Pilot Project 1: Understanding Relapse among Tribal Youth

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PROJECT SUMMARY/ABSTRACT Understanding common risk and protective factors for relapse among American Indian/Alaskan Native (AI/AN) adolescents in recovery from substance use disorders is essential for ensuring that relapse prevention programming is authentic, relevant, culturally appropriate, and effective. The overall goals for this Pilot Project are to (1) gain an in-depth understanding of the intrapersonal and interpersonal determinants of relapse among AI/AN youth in recovery from addiction by surveying consecutively-admitted AI/AN adolescent residents of the Healing Lodge of the Seven Nations (HL); (2) for the first time at the HL, integrate information collected as part of routine clinical services with original survey data to advance clinical research; and (3) engage in a variety of knowledge translation/research dissemination activities designed to return knowledge gained to AI/AN adolescents’ care communities. We will invite three cohorts of approximately 15 AI/AN HL residents to take part in a survey that assesses key demographics (i.e., age, gender, tribal reservation residence status), situational precursors to relapse (i.e., trigger experiences, crisis experiences, other potential missed intervention points), social community supports/networks, and intrapersonal characteristics (i.e., coping skills). We will follow a Tribal Participatory Research approach, whereby we will solicit the feedback regarding the research plan and instrumentation from a Working Group composed of representatives from seven surrounding tribal nations. Therefore, the final form of the survey will reflect the interests and perceived needs of tribal partners. We will combine survey information with relevant clinical information about HL residents, particularly comorbid psychiatric conditions and relapse history, collected at intake. We will describe the prevalence of risk and protective factors shared by AI/AN youth in the aggregate and supplement these descriptive analyses with subgroup analyses designed to explore potential interactions among measured variables, to advance tailored aftercare approaches designed to support AI/AN adolescents after they return to their home communities and work to maintain their recovery. We will employ best practices for conveying and disseminating research findings to a broad audience, which will include the Working Group, tribal councils, HL residents, and, perhaps most importantly, key HL staff including aftercare specialists. This Pilot Project will provide the foundation for a set of guided research experiences that will build professional clinical research capacity at the newly established Healing Lodge Research and Training Unit.