# Developing a Positive Approach to Substance Use Prevention in North American Indian Adolescents

> **NIH NIH R34** · UNIVERSITY OF RHODE ISLAND · 2020 · $218,169

## Abstract

Project Summary
 Alcohol is one of the primary determinants of health disparity among many Indigenous populations with
rates of alcohol-attributable mortality substantially higher than for Whites (73.8 per 100,000 vs. 27.5), and
therefore, is a key threat to optimal health and well-being to Indigenous youth. Indigenous youth living in both
the US and Canada tend to begin using alcohol, tobacco, and other drugs (ATOD) at earlier ages than most
other ethnic/racial groups, and tend to move more quickly to regular use, resulting in earlier onset of ATOD
disorders. Despite the severity of the problem, there continues to be an urgent unmet need for effective
prevention programs that are culturally tailored to Indigenous populations of the US and Canada. The overall
objective of this project is to develop and obtain preliminary data on the acceptability, feasibility, and initial
efficacy of Native PATHS (Positive Approaches to reducing Harm from Substance Use). Native PATHS is a
strengths-based, family prevention program for Indigenous youth in 5th-8th grade which focuses on delayed
ATOD initiation. The development of Native PATHS has been guided by our formative work in this community,
taking a behavioral economic and positive psychological approach to prevention. Applied to prevention,
behavioral economic theory focuses on reducing the availability of ATOD and increasing ATOD-free
alternatives and the reinforcement received from engaging in ATOD-free activities. Activities in Native PATHS
will work with families to help with establishing ATOD-free rules, limit physical availability of ATOD in the home,
and reinforce youths' participation in ATOD-free activities. Positive psychological interventions (PPIs) focus on
increasing positive emotions, life satisfaction, and well-being. PPIs will be used to enhance the enjoyment
received from ATOD-free activities and to improve life satisfaction. Native PATHS is culturally consistent with
North American Indigenous views of health that describe health in terms of a balance between the physical,
spiritual, emotional, and mental aspects of life, which is represented in the teachings of the Medicine Wheel.
Collaboratively we will work together with our tribal partner on further adaptation of our program to include
family and Indigenous ways of parenting in a culturally meaningful way. The overall goals proposed project will
1) finalize Native PATHS with participation from youth and family members in talking circles and an open pilot
trial; 2) assess the effectiveness of Native PATHS in reducing ATOD initiation and intentions to use ATOD. 3)
begin to evaluate the possible mechanisms/moderators of action including potential mediators future
orientation and alternative reinfocer/activity engagement and reinforcement received, compared to a wait-list
control group. We will also evaluate positive affect as a potential moderator of any treatment effect, such that
those higher in positive affect will be less likely to en...

## Key facts

- **NIH application ID:** 9978210
- **Project number:** 1R34AA027619-01A1
- **Recipient organization:** UNIVERSITY OF RHODE ISLAND
- **Principal Investigator:** Nichea Solomon Spillane
- **Activity code:** R34 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $218,169
- **Award type:** 1
- **Project period:** 2020-06-15 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9978210

## Citation

> US National Institutes of Health, RePORTER application 9978210, Developing a Positive Approach to Substance Use Prevention in North American Indian Adolescents (1R34AA027619-01A1). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9978210. Licensed CC0.

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