A Framework for Conducting a National Study of Substance Abuse Treatment Programs Serving American Indian and Alaska Native Communities

Abstract

Background: Because of their broad geographic distribution, diverse ownership and operation, and funding instability, it is a challenge to develop a framework for studying substance abuse treatment programs serving American Indian and Alaska Native communities at a national level. This is further complicated by the historic reluctance of American Indian and Alaska Native communities to participate in research. Objectives and Methods: We developed a framework for studying these substance abuse treatment programs (n ≈ 293) at a national level as part of a study of attitudes toward, and use of, evidence-based treatments among substance abuse treatment programs serving AI/AN communities with the goal of assuring participation of a broad array of programs and the communities that they serve. Results: Because of the complexities of identifying specific substance abuse treatment programs, the sampling framework divides these programs into strata based on the American Indian and Alaska Native communities that they serve: (1) the 20 largest tribes (by population); (2) urban AI/AN clinics; (3) Alaska Native Health Corporations; (4) other Tribes; and (5) other regional programs unaffiliated with a specific AI/AN community. In addition, the recruitment framework was designed to be sensitive to likely concerns about participating in research. Conclusion and Scientific Significance: This systematic approach for studying substance abuse and other clinical programs serving AI/AN communities assures the participation of diverse AI/AN programs and communities and may be useful in designing similar national studies.

• Indians
• North American
• substance abuse treatment centers
• research methods

ACKNOWLEDGMENTS

The preparation of this analysis and commentary was supported by the National Institute on Drug Abuse (R01-DA022239, Douglas Novins, Principal Investigator). This article was presented in part at the conference Building Bridges: Advancing American Indian/Alaska Native Substance Abuse Research: A State of the Science and Grant Development Workshop (October 5–10, 2010, sponsored by the National Institute on Drug Abuse). The Centers for American Indian and Alaska Native Health’s Substance Abuse Treatment Advisory Board includes the following members: Gregory Aarons (University of California, San Diego), Annie Belcourt-Dittloff (University of Montana), Gordon Belcourt (Montana-Wyoming Tribal Leaders Counsel), Sarah Conti, Dennis Dahlke, Raymond Daw (Navajo Nation Behavioral Health), Daniel Dickerson (United American Indian Involvement/University of California-Los Angeles), Darren Dry (Jack Brown Center), Candace Fleming (University of Colorado Anschutz Medical Campus), Alexandra Fickenscher (Emerita, University of Colorado Anschutz Medical Campus), John Gastorf (Cherokee Nation Behavioral Health), Craig Love (Westat), Kathleen Masis (Montana-Wyoming Tribal Leaders Council), Paul Spicer, (University of Oklahoma), and Traci Rieckmann (Oregon Health and Sciences University).

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.