# Development and Implementation of a Culturally Centered Opioid Prevention Intervention for American Indian/Alaska Native Young Adults in California

> **NIH NIH UH3** · RAND CORPORATION · 2021 · $359,323

## Abstract

PROJECT SUMMARY/ABSTRACT
American Indian/Alaska Native (AI/ANs) individuals experience some of the highest rates of co-occurring
mental health and substance use problems in the United States. These disparities reflect broader systemic and
community level inequities among urban-dwelling AI/AN individuals. Systemic factors, such as poverty,
unemployment, and discrimination are underlying barriers to accessing healthcare and substance use treatment,
affecting nearly a quarter of AI/AN people. Emerging adulthood (ages 18-25) is a developmental period often
characterized by instability, role transition, and self-exploration. Some evidence suggests that AI/AN emerging
adults often experience this key formative life stage while coping with discrimination, social and economic
inequities, and rapid cultural change, which all can affect mental health and substance use. However, little is
known about risk and protective factors among urban AI/AN emerging adults that may be associated with health
inequities. The aims of this supplement are within the scope of the parent grant; however, they substantially
expand the parent project by allowing us to analyze our survey baseline data in new ways, as well as combine
these survey data with new qualitative data: Aim 1- utilize baseline survey data (n=125) to examine how risk
factors (e.g., discrimination, historical loss), and protective factors-- cultural identity and connection (e.g.,
cultural connection, cultural identity, and participation in traditional practices), and social support (e.g.,
emotional, tangible, and support from rural or urban network contacts) are associated with opioid, alcohol and
cannabis use and mental health outcomes; and Aim 2- conduct in-depth interviews with a subsample of 20
participants recruited from the baseline sample who report different types of experiences (e.g., high rates of
discrimination/loss, high rates of cultural engagement, social networks with rural support, social networks with
urban support) to better understand urban AI/AN emerging adults’ experiences with discrimination and
historical loss, cultural identity and connection, and social support. Findings will support the parent grant by
providing new information on how to best address health equity among urban AI/AN emerging adults, given the
different risk and protective factors that they experience in their lives. Findings can help build an empirical,
culturally grounded rationale for how to enhance opioid and AOD prevention intervention services to ensure
equity for this population. This will be the first study to date to take a mixed methods approach to understand
specific structural drivers of inequity as well as key protective factors for AOD use and mental health among
urban AI/AN emerging adults. Findings can move the field forward in this understudied area by highlighting
how providers and policy makers can better address the inequities that AI/AN emerging adults experience.

## Key facts

- **NIH application ID:** 10440189
- **Project number:** 3UH3DA050235-03S1
- **Recipient organization:** RAND CORPORATION
- **Principal Investigator:** ELIZABETH J. D'AMICO
- **Activity code:** UH3 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $359,323
- **Award type:** 3
- **Project period:** 2019-09-30 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10440189

## Citation

> US National Institutes of Health, RePORTER application 10440189, Development and Implementation of a Culturally Centered Opioid Prevention Intervention for American Indian/Alaska Native Young Adults in California (3UH3DA050235-03S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10440189. Licensed CC0.

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