Partnership, knowledge translation, and substance abuse prevention with a First Nations community.

BACKGROUND: Having identified substance abuse as an issue of concern in their community, the Alexis Nakota Sioux Nation invited University of Alberta researchers to partner on the cultural adaptation, delivery, and evaluation of a school-based drug and alcohol abuse prevention program. Researchers conducted a literature review of available drug and alcohol prevention programs for children and youth, identifying the Life Skills Training (LST) program as a viable model for cultural adaptation. OBJECTIVES: Four program objectives were developed: (1) Review and cultural adaptation of the elementary and junior high LST programs, (2) delivery of the adapted programs, (3) measurement of changes in students' knowledge of the negative effects of drug and alcohol use, attitudes toward drugs and alcohol, drug and alcohol refusal and life skills, and changes in self-esteem/self-concept, and (4) documentation of the community's experience of the project. METHODS: Using the principles of community-based participatory research (CBPR), we employed both qualitative and quantitative methods to evaluate the impact of the project. RESULTS: Qualitative evaluation of the program adaptation and implementation were both positive. Qualitative measures of program impact on students revealed a positive effect, whereas results of the quantitative measures were mixed. CONCLUSIONS: Culturally adapted, evidence-based programs can have a positive effect on Aboriginal youth and their communities. Strategies to expand knowledge translation (KT) when working with Aboriginal communities include working to create an "ethical space" that draws on the strengths of both Western and Indigenous worldviews.

"Making a place of respect": lessons learned in carrying out consent protocol with First Nations elders.

BACKGROUND: This article explores the issue of informed consent by First Nations Elders modifying and implementing a substance abuse prevention program for youth, Nimi Icinohabi, among the Alexis Nakota Sioux Nation. The Elders who approved and guided the research maintained that informed consent procedures carried out by the Western academic institutions were redundant given adherence to their own culturally based protocol. OBJECTIVES: The objective of this article is to present lessons learned regarding the cultural basis of consent involving First Nations Elders to improve our own and other researchers' ethical practice in this context. METHODS: Two focus groups were held with our team of community and university-based researchers (n = 6) to discuss our experience of the Elder consent procedures used during the project. RESULTS: Elder involvement was integral to the success of the program. Using methods of consent originating from Western thought and given historical and ongoing issues of trust with Western institutions, signing consent forms was unacceptable to them and perceived as undermining their own ethical practices. An oral consent process utilizing cultural protocol and a tool to keep track of participation in this process was subsequently approved by our Research Ethics Board (REB) and used successfully. CONCLUSIONS: When researchers use standard informed consent practices, they risk losing the trust of community partners by undermining cultural values and practices. As academic researchers, it is our ethical responsibility, in the spirit of restorative justice, to honor the principles of beneficence and justice in research by ensuring consent within the context of cultural protocol.

A culturally adapted drug and alcohol abuse prevention program for aboriginal children and youth.

BACKGROUND: In response to substance abuse within their community, the Alexis Nakota Sioux Nation invited the University of Alberta (UofA) to partner in a collaborative effort to establish a school-based substance abuse prevention program. OBJECTIVES: An evidence-based substance abuse prevention program was reviewed and adapted by the community to ensure that it incorporated their cultural beliefs, values, language, and visual images. The adapted program was delivered to students at Alexis Nakota Sioux Nation School and changes in student participants' knowledge, attitudes, refusal skills, and self-beliefs were measured. Benefits and challenges of adapting the program were documented. METHODS: The principles of community-based participatory research (CBPR) and the Canadian Institute for Health Research, Guidelines for Research Involving Aboriginal People, provided a frame of reference for the work throughout the research process. A pre-/posttest questionnaire was used to measure changes in student participants' drug and alcohol refusal skills, self-beliefs, and knowledge of the negative effects of drug and alcohol use. Focus groups (FGs) documented community members' experiences of and responses to the program adaptations and delivery. RESULTS: Results included (1) positive changes in students' drug and alcohol refusal skills, self-beliefs, and knowledge of the negative effects of drug and alcohol use, (2) ownership of and investment in the program by the community, (3) teaching approaches that correspond with the learning contexts, worldview, and relationships of the community, and (4) participation of community Elders. CONCLUSION: Quantitative and qualitative measures provide evidence for the importance, benefits, and challenges of employing a culturally adapted evidence-based substance abuse prevention program with Aboriginal students attending a First Nations school.