# Randomized Clinical Trial of Harm Reduction Talking Circles for Urban American Indians and Alaska Natives with Alcohol Use Disorders

> **NIH NIH P60** · WASHINGTON STATE UNIVERSITY · 2022 · $199,934

## Abstract

RESEARCH PROJECT 2 ABSTRACT: Alcohol-use disorders (AUDs) are a serious public health issue for urban
American Indians and Alaska Natives (AI/ANs). They have twice the levels of AUDs and alcohol problems of
urban non-Hispanic whites. Unfortunately, the most widely available treatment option – abstinence-based
treatment – is generally ineffective in engaging and successfully treating this underserved population. To
illuminate potential solutions to this problem, we conducted pilot qualitative studies, in which urban AI/ANs with
AUDs expressed interest in interventions that integrate low-barrier, nonabstinence-based harm-reduction
approaches with Native cultural practices. The most commonly requested cultural practice was the talking circle.
A talking circle is a gathering of people with a common concern who respectfully share their perspectives and
“listen with their heart” while each individual speaks. Traditionally, talking circles have been used to address
community problems, heal individuals from trauma, and bring about community harmony. Recent studies
conducted with other populations have indicated talking circles may be an efficacious clinical intervention. We
propose to use a community-based participatory research framework to guide the refinement and formal
evaluation of Harm Reduction Talking Circles (HaRTC) for urban AI/ANs with AUDs. HaRTC will be designed
with a community advisory board made up of researchers, traditional Native healers, urban AI/ANs with the lived
experience of AUDs, and representatives from the Seattle Indian Health Board, the community partner for the
study. This project will be conducted in 3 phases: In Phase 1, we will collect qualitative data via interviews and
focus groups with Seattle Indian Health Board staff and the priority population. Qualitative analyses will elucidate
ways to optimally tailor HaRTC. In Phase 2, we will refine study procedures and HaRTC treatment manual using
qualitative data collected in Phase 1 and the guidance of the community advisory board. Phase 3 will comprise
a randomized controlled trial of HaRTC with 280 patients from the Seattle Indian Health Board primary care and
behavioral health clinics. Participants will be individually randomized to receive HaRTC or the clinic’s treatment
as usual services (control), and will be assessed at baseline, posttest (immediately following treatment end), 1-
, 3- and 6-month follow-ups. Quantitative analyses will test the efficacy of the HaRTC compared to treatment as
usual. Our Specific Aims are to 1) Tailor HaRTC to meet the needs of urban AI/ANs with AUDs in a clinical
setting; 2) Conduct a randomized controlled trial to evaluate the efficacy of HaRTC versus treatment as usual;
and 3) Perform a comprehensive economic evaluation of HaRTC with cost-benefit and cost-effectiveness
analyses. We expect that HaRTC participants will show greater improvements on alcohol outcomes and quality
of life compared to control participants and that the interven...

## Key facts

- **NIH application ID:** 10310686
- **Project number:** 5P60AA026112-05
- **Recipient organization:** WASHINGTON STATE UNIVERSITY
- **Principal Investigator:** Lonnie A. Nelson
- **Activity code:** P60 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $199,934
- **Award type:** 5
- **Project period:** 2017-12-15 → 2024-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10310686

## Citation

> US National Institutes of Health, RePORTER application 10310686, Randomized Clinical Trial of Harm Reduction Talking Circles for Urban American Indians and Alaska Natives with Alcohol Use Disorders (5P60AA026112-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10310686. Licensed CC0.

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