Prevention Trial in the Cherokee Nation

To prevent and reduce alcohol use and related problems among high school students, Cherokee Nation Behavioral Health (Kominsky, Pettigrew, Garrett) and Emory prevention scientists (Komro, PI; Wagenaar & Crawford, Co-Investigators; Rentmeester, Project Coordinator) worked together to implement and evaluate two evidence-based programs.

Communities Mobilizing for Change on Alcohol (CMCA) utilizes a community organizing approach to engage local citizens in working together to prevent or reduce alcohol use among teenagers. Become a community organizer and help your community prevent underage alcohol and drug use. Read our CMCA Guide, Sample Tool Kit, and Fact Sheets.

 

CONNECT is a school-based brief intervention providing support and motivation to prevent or reduce alcohol use among teens. Practice motivating teens to change their drinking behaviors. Watch our motivational interviewing training videos. Also, view the postcards we sent to families to inform them about consequences of alcohol among teens and tips to prevent their use and keep them safe.

The Prevention Trial engaged 9th and 10th graders in six northeastern Oklahoma communities over three years. One town received CONNECT, one town received CMCA, two towns received both, and two towns received CMCA after the active study period. All participants took the Youth Experiences Survey four times per year. On the survey, we measured: 1) frequency of alcohol use in the past 30 days, and 2) frequency of having five or more drinks in a row in the past 30 days.


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Our results showed that students in each intervention group had reduced 30-day alcohol use, heavy alcohol use and less alcohol-related consequences over time. Teens in the CMCA towns had reduced alcohol use and alcohol-related consequences by about 25%. Teens in the CONNECT schools also had reduced alcohol use and alcohol-related consequences by about 25%. Reductions in alcohol use varied over time and were the most pronounced when the CMCA chapters were most active, during the first two years.

 

 

 

We are currently working on publishing the main results from the study. Please see the publications below for additional intervention and study details:

Garrett, B.A. Livingston, B.J., Livingston, M.D., & Komro, K.A. (2017). The Effects of Perceived Racial/Ethnic Discrimination on Substance Use among Youth Living in the Cherokee Nation. Journal of Child and Adolescent Substance Abuse, 26(3), 242-249.  DOI: 10.1080/1067828X.2017.1299656.

Komro, K.A., Livingston, M.D., Wagenaar, A.C. Pettigrew, D.W., Garrett, B.A. & Cherokee Nation Prevention Trial Team. (2017). Multilevel Prevention Trial of Alcohol Use Among American Indian and White High School Students in the Cherokee Nation.  American Journal of Public Health, 107(3), 453-459.  Cherokee National Prevention Trial Team members in alphabetical order include: Misty L. Boyd, Billy J. Boyd, Bethany J. Livingston, Sara D. Lynne-Landsman, Mildred Maldonado Molina, Lisa J. Merlo, and Amy L Tober: DOI: 10.2015/AJPH.2016.303603.

Komro, K.A., Livingston, M.D., Garrett, B.A., & Boyd, M.L. (2016). Similarities in the etiology of alcohol use among Native American and non-Native young women. Journal of Studies on Alcohol and Drugs, 77(5), 782-791.

Lynne-Landsman, S.D., Kominsky, T.K., Livingston, M.D., Wagenaar, A.C. & Komro, K.A. (2016). Alcohol sales to youth: Data from rural communities within the Cherokee Nation. Prevention Science, 17, 32-39.

Lynne-Landsman, S.D., Komro, K.A., Kominsky, T.K., Boyd, M.L., & Maldonado Molina, M.M. (2016). Early trajectories of alcohol and other substance use among youth from rural communities within the Cherokee Nation. Journal of Studies on Alcohol and Drugs, 77, 238-248.

Komro, K.A., Livingston, M.D., Kominsky, T.K., Livingston, B.J., Garrett, B.A., Maldonado-Molina, M.M. & Boyd, M. (2015). 15-minute comprehensive alcohol risk survey: Reliability and validity across American Indian and White adolescents. Journal of Studies on Alcohol and Drugs, 76(1), 133-142.

Komro, K.A., Wagenaar, A.C., Boyd, M., Boyd, B.J., Kominsky, T., Pettigrew, D., Tobler, A.L., Lynne-Landsman, S.D., Livingston, M.D., Livingston, B., & Maldonado Molina, M.M. (2015). Prevention trial in the Cherokee Nation: Design of a randomized community trial. Prevention Science, 16(2): 291-300.

Komro, K.A., Tobler, A.L., Delisle, A.L., O’Mara, R.J., & Wagenaar, A.C. (2013). Beyond the clinic: Improving child health through evidence-based community development. BMC Pediatrics, 13, 172.

Komro, K. A., & Toomey, T. L. (2002). Strategies to prevent underage drinking. Alcohol Research and Health, 26(1), 5-14.

Wagenaar, A. C., Murray, D. M., Gehan, J. P., Wolfson, M., Forster, J. L., Toomey, T. L., ... & Jones-Webb, R. (2000). Communities mobilizing for change on alcohol: outcomes from a randomized community trial. Journal of Studies on Alcohol, 61(1), 85-94.

Wagenaar, A.C., Murray, D.M., Toomey, T.L. (2000). Communities Mobilizing for Change on Alcohol (CMCA): Effects of a randomized trial on arrests and traffic crashes. Addiction 95, 209–217.

Wagenaar AC, Gehan JP, Jones-Webb R, et al. (1999). Communities mobilizing for change on Alcohol: Lessons and results from a 15-community randomized trial.  Journal of Community Psychology, 27(3), 315–326.

Wagenaar, A.C., Murray, D.M., Wolfson, M., Forster, J.L., Finnengan, J.R. (1994). Community mobilizing for change on alcohol: design of a randomized community trial. Journal of Community Psychology (CSAP Special Issue), 79–101.