Abstract
The Elluam Tungiinun and Yupiucimta Asvairtuumallerkaa studies evaluated the feasibility of a community intervention to prevent suicide and alcohol abuse among rural Yup’ik Alaska Native youth in two remote communities. The intervention originated in an Indigenous model of protection, and its development used a community based participatory research process. Feasibility assessment aimed to assess the extent to which (1) the intervention could be implemented in rural Alaska Native communities, and (2) the intervention was capable of producing measurable effects. Scales maximally sensitive to change were derived from earlier measurement work, and the study contrasted implementation process and outcomes across the two communities. In one community, medium dose response effects (d = .30–.50), with dose defined as number of intervention activities attended, were observed in the growth of intermediate protective factors and ultimate variables. In the other community, medium dose effects were observed for one intermediate protective factor variable, and small dose effects were observed in ultimate variables. Differences across communities in resources supporting intervention explain these contrasting outcomes. Results suggest implementation in these rural Alaska settings is feasible when sufficient resources are available to sustain high levels of local commitment. In such cases, measureable effects are sufficient to warrant a prevention trial.
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Notes
Through out the paper, we will use Indigenous in its capitalized form to refer here to the original inhabitants of Alaska (Alaska Native people), and the lower case indigenous to refer more generally to the concept of local and locally developed theory.
The process used to develop the original measures is described in Gonzalez and Trickett (2014), the procedures used in measurement development are described in Allen (Appendix S1 to Gonzalez and Trickett, 2014), and more detailed description of the original scales and the test of the measurement model is described in Allen et al. (2014b).
For the YA Intervention analysis, the HLM notation did not include the ‘cohort’ terms.
References
Alakanuk Community Planning Group, Allen, J., Alstrom, D., Burkett, R., Campbell, D., Chikigak, A., et al. (2008). Qungasvik: A toolbox for promoting youth sobriety and reasons for living in Yup’ik/Cup’ik communities. Fairbanks, AK: Center for Alaska Native Health Research, University of Alaska Fairbanks.
Allen, J., Mohatt, G. W., Hazel, K. L., Rasmus, M., Thomas, L. R., Lindley, S., et al. (2006). The tools to understand: Community as co-researcher on culture specific protective factors for Alaska Natives. Journal of Prevention and Intervention in the Community, 32, 41–64. doi:10.1300/J005v32n01_04.
Allen, J., Levintova, M., & Mohatt, G. V. (2011). Suicide and alcohol related disorders in the U.S. Arctic: Boosting research to address a primary determinant of circumpolar health disparities. International Journal of Circumpolar Health, 70, 473–487.
Allen, J., Fok, C. C. T., Henry, D., Skewes, M., & People Awakening Team. (2012). Umyuangcaryaraq “reflecting”: Multidimensional assessment of reflective processes about the consequences of alcohol use among Yup’ik Alaska Native youth. American Journal of Drug and Alcohol Abuse, 38(5), 468–475. doi:10.3109/00952990.2012.702169.
Allen, J., Mohatt, G. V., Beehler, S., & Rowe, H. L. (2014a). People Awakening: Collaborative research with Alaska Native communities to address alcohol use disorders and suicide related health disparities. American Journal of Community Psychology.
Allen, J., Mohatt, G. V., Fok, C. C. T., Henry, D., Burkett, R., & People Awakening Team (2014b). A protective factors model for alcohol abuse and suicide prevention among Alaska Native youth. American Journal of Community Psychology.
Beauvais, F. (1990). The need for community consensus as a condition of policy implementation in the reduction of alcohol abuse on Indian reservations. American Indian and Alaska Native Mental Health Research, 4(3), 77–81. doi:10.5820/aian.0403.1990.77.
Berman, M., Hull, T., & May, P. (2000). Alcohol control and injury death in Alaska Native communities: Wet, damp and dry under Alaska's local option law. Journal of Studies on Alcohol, 61(2), 311–319.
Bond, T. G., & Fox, C. M. (2001). Applying the Rasch model: Fundamental measurement in the human sciences. London: Lawrence Erlbaum Associates.
Brown, C. E., Wyman, P. A., Guo, J., & Pena, J. (2006). Dynamic wait-listed designs for randomized trails: New designs for prevention of youth suicide. Society for Clinical Trials, 3, 259–271. doi:10.1191/1740774506cn152oa.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale: Erlbaum.
Collins, L. M., & Cliff, N. (1990). Using the longitudinal Guttman simplex as a basis for measuring growth. Psychological Bulletin, 108, 128–134. doi:10.1037//0033-2909.108.1.128.
Fok, C. C. T., Allen, J., Henry, D., Mohatt, G. V., & People Awakening Team. (2011a). The multicultural mastery scale for youth: Multidimensional assessment of culturally mediated coping strategies. Psychological Assessment, 24, 313–327. doi:10.1037/a0025505.
Fok, C .C. T., Allen, J., Henry, D., & People Awakening Team. (2011b). The Brief Family Relationships Scale: An adaptation of the relationship dimension of the family environment scale assessment. Prepublished November 14, 2011. doi:10.1177/1073191111425856.
Gone, J. P. (2007). We never was happy living like a Whiteman: Mental health disparities and the postcolonial predicament in American Indian communities. American Journal of Community Psychology, 40(3–4), 290–300. doi:10.1007/s10464-007-9136-x.
Gone, J. P., & Trimble, J. E. (2012). American Indian and Alaska Native mental health: Diverse perspectives on enduring disparities. Annual Review of Clinical Psychology, 8, 131–160.
Gonzalez, J., & Trickett, E. (2014). Collaborative measurement development as a tool in CBPR: Measurement development and adaptation within the cultures of communities. American Journal of Community Psychology. doi:10.1007/s10464-014-9655-1.
Gwet, K. (2001). Handbook of inter-rater reliability: How to estimate the level of agreement between two or multiple raters. Gaithersburg, MD: STATAXIS Publishing Company.
Hawe, P., Shiell, A., & Riley, T. (2004). Complex interventions: How “out of control” can a randomised controlled trial be? British Medical Journal, 328(7455), 1561–1563. doi:10.1136/bmj.328.7455.1561.
Hedeker, D., & Gibbons, R. D. (2006). Longitudinal data analysis. Hoboken, NJ: Wiley-Interscience.
Henry, D. B., Tolan, P. H., & Gorman-Smith, D. (2005). Cluster analysis in family psychology research. Journal of Family Psychology, 19, 121–132. doi:10.1037/0893-3200.19.1.121.
Henry, D., Allen, J., Fok, C. C. T., Rasmus, S., Charles, W., & People Awakening Team. (2012). Patterns of protective factors in an intervention for the prevention of suicide and alcohol abuse with Yup’ik Alaska Native youth. American Journal of Drug and Alcohol Abuse, 38, 476–482. doi:10.3109/00952990.2012.704460.
Insightful Corporation. (2005). Getting started with S-PLUS 7 for windows. Washington: Insightful.
Jackson, T., McKenzie, J., & Hobfoll, S. E. (2000). Communal aspects of self-regulation. In M. Boekaerts, P. R. Pintrich, & M. Zeider (Eds.), Handbook of self-regulation. San Diego, CA: Academic Press.
Linehan, M. M., Goodstein, A. J., Nielsen, S. L., & Chiles, J. A. (1983). Reasons for staying alive when you are thinking about killing yourself: The reasons for living inventory. Journal of Consulting and Clinical Psychology, 51, 276–286. doi:10.1037//0022-006X.51.2.276.
Medical Research Council. (2000). A framework for development and Evaluation of RCTs for complex interventions to improve health. London: Medical Research Council.
Mohatt, G. V., Rasmus, S. M., Thomas, L., Allen, J., Hazel, K., Hensel, C., et al. (2004). Tied together like a woven hat: Protective pathways to sobriety for Alaska Natives. Harm Reduction Journal, 1, 10. doi:10.1186/1477-7517-1-10.
Mohatt, G. V., Rasmus, S. M., Thomas, L., Allen, J., Hazel, K., Marlatt, G. A., et al. (2007). Risk, resilience, and natural recovery: A model of recovery from alcohol abuse for Alaska Natives. Addiction, 103, 205–215.
Mohatt, N., Fok, C. C. T., Burket, R., Henry, D., & Allen, J. (2011). The Ellangumaciq Awareness Scale: Assessment of awareness of connectedness as a culturally-based protective factor for Native American youth. Cultural Diversity and Ethnic Minority Psychology, 17, 444–455.
Moos, R. H., & Moos, B. S. (1994). Family environment scale (3rd ed.). Palo Alto, CA: Consulting Psychologists Press.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory. New York, NY: McGraw-Hill.
Oetting, E. R., & Beauvais, F. (1990). Adolescent drug use: Findings of national and local surveys. Journal of Consulting and Clinical Psychology, 58, 385–394. doi:10.1037//0022-006X.58.4.385.
Osman, A., Kopper, B., Barrios, F., Osman, J., Besett, T., & Linehan, M. (1996). The brief reasons for living inventory for adolescents (BRFL-A). Journal of Abnormal Child Psychology, 24, 433–443. doi:10.1007/BF01441566.
Pinheiro, J. C., & Bates, M. D. (2004). Mixed-effects models in S and S-PLUS. New York: Springer. doi:10.1007/978-1-4419-0318-1.
Raudenbush, S. W., & Bryk, A. S. (2002). Hierarchical linear models: Application and data analysis methods (2nd ed.). Thousand Oaks, CA: Sage.
Rasmus, S., Mohatt, G. V., Ebbesson, G., Alstrom, D., Hubalik, N., Moses, C., Nicolai, D., Elluam Tungiinun Community Planning Group, & Yupiucimta Asvairtuumallerkaa Community Planning Group (2014). Grounding intervention in culture: Description of a community based participatory process of community intervention development. American Journal of Community Psychology.
Rubin, D. (1974). Estimating causal effects of treatments in randomized and nonrandomized studies. Journal of Educational Psychology, 66, 688–701.
Samejima, F. (1997). Graded response model. In W. J. van der Linden & R. K. Hambleton (Eds.), Handbook of modern item response theory (pp. 85–100). New York, NY: Springer.
Schensul, J. J., & Trickett, E. (2009). Introduction to multi-level community based culturally situated interventions. American Journal of Community Psychology, 43, 232–240. doi:10.1007/s10464-009-9238-8.
Singer, J. D., & Willett, J. B. (2003). Applied longitudinal data analysis: Modeling change and event occurrence. New York, NY: Oxford University Press.
Trickett, E. J. (2011). Community-based participatory research as worldview or instrumental strategy: Is it lost in translation(al) research? American Journal of Public Health, 101(8), 1353–1355. doi:10.2105/AJPH.2011.300124.
Trickett, E. J., Beehler, S., Deutsch, S., Green, L. W., Hawe, P., McLeroy, K., et al. (2011). Advancing the science of community-level interventions. American Journal of Public Health, 101(8), 1410–1419.
Acknowledgments
This research was funded by the National Institute of Alcohol Abuse and Alcoholism, the National Institute for Minority Health and Health Disparities, and the National Center for Research Resources (R21 AA016098-01; RO1AA11446; R21AA016098; R24 MD001626; P20RR061430). We also want to thank all of the People Awakening Team including participants, community co-researchers, our Coordinating Council and our project staff for their assistance in completing this research.
People Awakening Team Members
The People Awakening Team includes the Yupiucimta Asvairtuumallerkaa Councils, the Ellangneq Councils, the Yup’ik Regional Coordinating Council, the Ellangneq Advisory Group, and the Ellangneq, Yupiucimta Asvairtuumallerkaa, and Cuqyun Project Staff. The Yupiucimta Asvairtuumallerkaa Councils included Sophie Agimuk, Harry Asuluk, Thomas Asuluk, T.J. Bentley, John Carl, Mary Carl, Emily Chagluk, James Charlie, Sr., Lizzie Chimiugak, Ruth Jimmie, Jolene John, Paul John, Simeon John, Aaron Moses, Phillip Moses, Harry Tulik, and Cecelia White. The Ellangneq Councils includes Catherine Agayar, Fred Augustine, Mary Augustine, Paula Ayunerak, Theresa Damian, Lawrence Edmund, Sr., Barbara Joe, Lucy Joseph, Joe Joseph, Placide Joseph, Zacheus Paul, Charlotte Phillp, Henry Phillip, Joe Phillip, Penny Alstrom, Fred Augustine, Mary Augustine, Paula Ayunerak, Theresa Damian, Shelby Edmund, Flora Patrick, Dennis Sheldon, Isidore Shelton, Catherine Agayar, Theresa Damian, Freddie Edmund, Shelby Edmund, Josie Edmund, and Flora Patrick. The Yup’ik Regional Coordinating Council includes Martha Simon, Moses Tulim, Ed Adams, Tammy Aguchak, Paula Ayunerak, Sebastian Cowboy, Lawrence Edmunds, Margaret Harpak, Charles Moses, Raymond Oney. The Ellangneq Advisory Group includes Walkie Charles, Richard Katz, Mary Sexton, Lisa Rey Thomas, Beti Thompson, and Edison Trickett. The Ellangneq Project Staff includes Debbie Alstrom, Carl Blackhurst, Rebekah Burkett, Diana Campbell, Arthur Chikigak, Gunnar Ebbesson, Aaron Fortner, John Gonzalez, Scarlett Hopkins, Nick Hubalik, Joseph Klejka, Charles Moses, Dora Nicholai, Eliza Orr, Marvin Paul, Michelle Dondanville, Jonghan Kim, Rebecca Koskela, Johanna Herron, and Stacy Rasmus.
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This paper is published posthumously for Gerald V. Mohatt.
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Mohatt, G.V., Fok, C.C.T., Henry, D. et al. Feasibility of a Community Intervention for the Prevention of Suicide and Alcohol Abuse with Yup’ik Alaska Native Youth: The Elluam Tungiinun and Yupiucimta Asvairtuumallerkaa Studies. Am J Community Psychol 54, 153–169 (2014). https://doi.org/10.1007/s10464-014-9646-2
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DOI: https://doi.org/10.1007/s10464-014-9646-2