A review of tribal best practices in substance abuse prevention

ABSTRACT

American Indian youth experience higher rates of substance use than non-American Indian youth. Researchers, clinicians, and treatment programs embrace evidence-based practices (EBPs) and practice based evidence (PBE) as a primary method for addressing substance abuse and advancing behavioral health. However, less is known about the use of tribal best practices (TBPs) and how they are implemented in American Indian substance use prevention contexts. Objective: The main objective of this systematic review was to determine how TBPs are implemented and shared in the context of tribal substance use prevention. The second objective was to document TBP examples from three tribal communities involved in a 5-year substance use prevention initiative. Methods: A systematic review of published and grey literature was conducted using funding agencies websites, EBSCO Host and national registries. Three tribal communities involved in the initiative documented current TBPs to highlight characteristics of TBPs, costs, and approval processes. Results: TBPs are very limited in the literature. Despite tribal use for thousands of years, TBPs are underrepresented and misunderstood. This review found that the terminology used to describe TBPs is not consistent across agencies, publications, websites, or reports. There is also variation in how TBPs originate in substance use prevention contexts and there is not a primary resource or protocol for sharing TBPs. Continued efforts are needed to support the use and dissemination of TBPs in substance use prevention.

KEYWORDS:

• American Indian youth
• evidence-based interventions and practices
• substance use
• tribal best practices

Acknowledgment

In May 2015, the authors attended a two-day tribal best practice (TBP) workshop taught by Caroline Cruz. During this workshop, authors learned about the history of TBPs and how the State of Oregon has been successful in establishing TBPs to address behavioral health and substance use needs in place of EBPs. This manuscript and the three TBPs highlighted were informed by this workshop. Authors worked with tribal site coordinators to document TBPs being used in tribal communities. Examples of these TBPs are included in this manuscript to increase understanding and visibility of TBPs.

Additional information

Funding

This work was supported by the Substance Abuse and Mental Health Services Administration [Grant Number SAMSHA grant # 5U79SP020702-03 CFDA 93.243].