Formative research and cultural tailoring of a substance abuse prevention program for American Indian youth

by Rachel Girarda, PATHS Lab, Department of Psychology, University of Rhode Island, Kingston, RI, USA

Background: American Indian communities consistently identify adolescent substance use as a major concern. However, limited empirical work has examined how culturally specific protective factors – such as family disapproval and cultural affiliation – interact to influence substance use behavior. Given the importance of kinship networks and cultural continuity, understanding these dynamics is critical for informing culturally grounded prevention strategies.

Objectives: This study examines the moderating role of cultural affiliation in the association between family disapproval of substance use and actual use among American Indian adolescents, a population often excluded from national health datasets.

Methods: Secondary analysis was conducted using self-report data from the Our Youth, Our Future study, a nationally representative sample of American Indian adolescents attending schools on or near reservations (N = 8,950; 51% female; Mage = 14.64 years, SD = 1.77).

Results: Multilevel analyses revealed that family disapproval was negatively associated with lifetime alcohol (b = −0.15, p < .001) and cannabis use (b = −0.34, p < .001), controlling for age. Among adolescents who endorsed use, cultural affiliation moderated the relationship between family disapproval and past-year alcohol and cannabis use. Specifically, family disapproval was significantly associated with lower alcohol use at high (b = −0.01, p = .002) but not low (b = −0.07, p = .48) levels of cultural affiliation. For cannabis use, the association was stronger at high (b = −0.51, p < .001) versus low (b = −0.32, p = .005) levels.

Conclusions: Cultural affiliation strengthens the protective effects of family disapproval on substance use among American Indian youth. Findings support culturally responsive, family-based prevention efforts that promote cultural identity and intergenerational communication.

Source: https://www.tandfonline.com/doi/full/10.1080/00952990.2025.2535557?src=