# Factors and Training Approaches that Enhance the Integration of American Indian Culture into Tele-Behavioral Substance Use/Substance Use Disorders Treatment.

> **NIH NIH R25** · NORTHERN ARIZONA UNIVERSITY · 2021 · $99,999

## Abstract

PROJECT SUMMARY
In comparison to other groups, there are clear disparities in the higher rates of substance abuse, post-
traumatic stress, violence, and suicide in American Indian/Alaska Natives (AI/AN). High rates of substance
misuse in AI/AN communities is associated with unemployment, low academic performance, high-risk
occupations, violence, domestic abuse, delinquency, lack of health insurance, mental illness, and mortality
from suicide, alcohol, or other substance abuse. Substance use disorders (SUD) disproportionately impact
AI/ANs in Arizona due to the lack of infrastructure and personnel on reservations needed to deliver evidence-
based comprehensive treatment and prevention services. In addition, the lack of culturally-centered treatment
is a barrier to AI/AN individuals living in both rural and urban areas. The COVID-19 pandemic has exposed
well-established racial disparities in health care access and health outcomes in underserved communities.
COVID-19 has particularly had devastating impacts on tribal communities in Arizona. People with SUD may be
particularly at-risk for COVID-19 complications due to the effect of many drugs on respiratory and pulmonary
health, and higher likelihood of homelessness, incarceration, and co-morbid health conditions than the general
population. Given existing barriers to telehealth in providing comprehensive care for AI/AN and rural
communities, the COVID-19 pandemic may have placed those with behavioral health issues and SUDs at even
higher risk. Training a workforce to research the delivery of culturally-centered behavioral health and addiction
care with telehealth as a viable option has the potential to reduce the lasting impact of COVID-19 in
underserved populations and prevent disruption of substance use treatment. The overall goal of the parent
R25, Culturally-Centered Addictions Research Training (C-CART) (1R25DA053805), is to educate clinicians,
providers, and doctoral students in health professions (occupational therapy [OT], physical therapy [PT],
counseling, school, & clinical psychology, and interdisciplinary health) in research skills that include culturally-
centered practices, related to SU/SUDs applied in interprofessional practice and diverse settings.This
proposed Supplement to our R25 will look at Native culture and traditional practices within tele-behavioral
SU/SUD treatment at one of our community partner agencies – Native Americans for Community Action
(NACA) - and determine the impact on behavioral health outcomes for clients during the first year of the
COVID-19 pandemic. The specific aims of this project are: Aim 1: To understand the integration of Native
culture and traditional practices within tele-behavioral SU/SUD treatment at NACA and explore its impact on
behavioral health outcomes during the COVID-19 pandemic employing a mixed methods research design; and
Aim 2: To incorporate the findings from Aim 1 into a tele-behavioral SU/SUD treatment training module that will
be pi...

## Key facts

- **NIH application ID:** 10441963
- **Project number:** 3R25DA053805-01S1
- **Recipient organization:** NORTHERN ARIZONA UNIVERSITY
- **Principal Investigator:** Julie A. Baldwin
- **Activity code:** R25 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $99,999
- **Award type:** 3
- **Project period:** 2021-09-15 → 2022-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10441963

## Citation

> US National Institutes of Health, RePORTER application 10441963, Factors and Training Approaches that Enhance the Integration of American Indian Culture into Tele-Behavioral Substance Use/Substance Use Disorders Treatment. (3R25DA053805-01S1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10441963. Licensed CC0.

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