title: Use of evidence-based treatments in substance abuse treatment programs serving American Indian and Alaska Native communities.
abstract: BACKGROUND
  Research and health surveillance activities continue to document the substantial disparities in the impacts of substance abuse on the health of American Indian and Alaska Native (AI/AN) people. While Evidence-Based Treatments (EBTs) hold substantial promise for improving treatment for AI/ANs with substance use problems (as they do for non-AI/ANs), anecdotal reports suggest that their use is limited. In this study, we examine the awareness of, attitudes toward, and use of EBTs in substance abuse treatment programs serving AI/AN communities.
  
  
  METHODS
  Data are drawn from the first national survey of tribal substance abuse treatment programs. Clinicians or clinical administrators from 192 programs completed the survey. Participants were queried about their awareness of, attitudes toward, and use of 9 psychosocial and 3 medication EBTs.
  
  
  RESULTS
  Cognitive Behavioral Therapy (82.2%), Motivational Interviewing (68.6%), and Relapse Prevention Therapy (66.8%) were the most commonly implemented psychosocial EBTs; medications for psychiatric comorbidity was the most commonly implemented medication treatment (43.2%). Greater EBT knowledge and use were associated with both program (e.g., funding) and staff (e.g., educational attainment) characteristics. Only two of the commonly implemented psychosocial EBTs (Motivational Interviewing and Relapse Prevention Therapy) were endorsed as culturally appropriate by a majority of programs that had implemented them (55.9% and 58.1%, respectively).
  
  
  CONCLUSIONS
  EBT knowledge and use is higher in substance abuse treatment programs serving AI/AN communities than has been previously estimated. However, many users of these EBTs continue to have concerns about their cultural appropriateness, which likely limits their further dissemination.
authors.affiliation: Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, United States. Electronic address: douglas.novins@ucdenver.edu.
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Novins
authors.affiliation: Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, United States.
authors.forename: Calvin D
authors.initials: CD
authors.lastname: Croy
authors.affiliation: Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, United States.
authors.forename: Laurie A
authors.initials: LA
authors.lastname: Moore
authors.affiliation: Department of Public Health and Preventive Medicine, Oregon Health and Sciences University, United States.
authors.forename: Traci
authors.initials: T
authors.lastname: Rieckmann
mesh_terms: D000072957:Alaska Natives / Q000523:psychology / Q000706:statistics & numerical data; D055317:Evidence-Based Practice / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D007198:Indians, North American / Q000523:psychology / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000523:psychology* / Q000628:therapy*; D011795:Surveys and Questionnaires; D014481:United States
keywords: Diffusion of innovation; Indians; North American; Substance abuse treatment centers