Pilot evaluation of a Lakota-centered lifespan mentoring program to reduce alcohol related problems and promote holistic wellbeing

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Project Summary American Indians (AIs) experience disproportionately high rates of alcohol-related problems (ARPs) including hazardous alcohol use (e.g., HAU; heavy intensive or binge drinking) and alcohol-related consequences (ARC; health, safety, legal, and social problems including injury and death) as compared to any other racial/ethnic groups in the U.S.ARPs also hinder holistic well-being (HWB; mental, emotional, physical, and spiritual health) among AI peoples. ARPs among AI peoples is often intergenerational; rooted in social and structural conditions; and related to loss/lack of cultural identity, social isolation, and deficits in healthy coping and life skills. Despite an increasing understanding of etiological factors related to ARPs for AI peoples and a growing number of culturally tailored (often surface level), mostly individually-focused programs to prevent and treat ARPs among AIs, there is limited research evaluating AI-developed, culturally centered programs for AI people that focus on foundational factors (e.g., trauma, loss, isolation) underlying ARPs. A highly promising approach to reduce ARPs among AIs and promote holistic well-being is a culturally centered mentoring program that has been developed and is currently being implemented by a Lakota-led nonprofit, Oaye Luta Okolakiciye (OLO). The OLO mentoring program seeks to foster Lakota cultural identity, social connectedness, and healthy coping and like skills through peer support, cultural immersion, traditional healing and skills training. Despite its strong potential for reducing ARPs and promoting HWB among AI people, the culturally centered OLO mentoring program has not been formally evaluated. The proposed project seeks to address this gap in preparation for a fully powered R01. We have assembled an interdisciplinary team of Lakota stakeholders (e.g., Traditional Knowledge Keepers, Elders, and Lakota health professionals) and highly accomplished action-oriented researchers to lead this work. Aim 1 (Process Evaluation) includes documenting the OLO mentoring program processes, strengths, challenges, acceptability and feasibility via a review of all OLO documentation (e.g., operating manuals) (Aim 1a), interviews with OLO mentoring program stakeholders (Aim 1b), and mentor- mentee program engagement via weekly tracking logs (Aim 1c). Aim 2 (Outcome Evaluation) tests the hypothesis that the OLO mentoring program will positively impact intermediary outcomes (i.e., Lakota cultural identity, social connectedness, healthy life and coping skills) (Aim 2a). Given the lack of feasibility to recruit a large enough sample, information about primary outcomes (i.e., reductions in HAU/ARC, alcohol abstinence, and holistic well-being) will be collected primarily for descriptive purposes to inform a more rigorous R01 design (Aim 2b). Using matched mentor-mentee responses, we will examine how perceptions of the mentoring process impact intermediary outcomes (Aim 2c). Finally, we will examine how mentee program engagement impacts outcomes (Aim 2d). To complete these aims, mentees (n=50) will complete baseline, immediate-post- test, and six-month post program surveys. Mentors (n=10) will also complete an immediate post-test.