title: Pilot Outcome Results of Culturally Adapted Evidence-Based Substance Use Disorder Treatment with a Southwest Tribe.
abstract: BACKGROUND
  Although American Indians/Alaska Natives (AI/ANs) have exhibited high rates of alcohol and drug use disorders, there is a paucity of substance use disorder treatment outcome research. In addition, there exists controversy about whether evidence-based treatments (EBTs) are culturally appropriate given they were derived mainly by and for non-Hispanic White populations and do not explicitly include aspects of AI/AN culture and worldview.
  
  
  METHODS
  In this pilot study, we collaboratively culturally adapted two EBTs, Motivational Interviewing and Community Reinforcement Approach (MICRA), and evaluated substance use and psychological outcomes at 4- and 8-months post baseline assessment. In preparation for a larger randomized clinical trial (RCT), eight tribal members (75% male) participated in this pilot treatment study. Measures included substance use, urine screens, self-efficacy, psychological distress, and hopelessness. All participants completed follow-up assessments at 4- and 8-months. Due to small sample size, effect sizes were calculated to evaluate outcomes pre- and post-treatment.
  
  
  RESULTS
  Despite high rates of abstinence at baseline, percent days abstinent (PDA) increased at the 8-month time point for the most commonly used substances (alcohol, Hedges'sg= 0.59, and marijuana,g= 0.60) and for all substances combined (excluding tobacco,g= 0.56). Improvements in psychological distress (g= -0.66) and 5 of the 7 Addiction Severity Index domains (range ofg= -0.42 to -0.98) also emerged.
  
  
  CONCLUSIONS
  Results suggest that culturally adapted EBTs yield significant improvements in alcohol use, psychological distress, and legal problems among AI/ANs. Future research using RCT methodology is needed to examine efficacy and effectiveness.
authors.affiliation: University of New Mexico, Department of Psychology, 1 University of New Mexico, MSC 03 2220, Albuquerque, NM 87131; Center on Alcoholism, Substance Abuse, and Addictions, 2650 Yale Blvd. SE, Albuquerque, NM 87106.
authors.forename: Kamilla L
authors.initials: KL
authors.lastname: Venner
authors.affiliation: University of Minnesota, Duluth, 1049 University Dr, Duluth, MN 55812.
authors.forename: Brenna L
authors.initials: BL
authors.lastname: Greenfield
authors.affiliation: University of New Mexico, Department of Psychology, 1 University of New Mexico, MSC 03 2220, Albuquerque, NM 87131; Center on Alcoholism, Substance Abuse, and Addictions, 2650 Yale Blvd. SE, Albuquerque, NM 87106.
authors.forename: Kylee J
authors.initials: KJ
authors.lastname: Hagler
authors.affiliation: University of New Mexico, Department of Psychology, 1 University of New Mexico, MSC 03 2220, Albuquerque, NM 87131.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Simmons
authors.affiliation: Anonymous Tribal Agency.
authors.forename: Donna
authors.initials: D
authors.lastname: Lupee
authors.affiliation: Anonymous Tribal Agency.
authors.forename: Everett
authors.initials: E
authors.lastname: Homer
authors.affiliation: Anonymous Tribal Agency.
authors.forename: Yvette
authors.initials: Y
authors.lastname: Yamutewa
authors.affiliation: University of New Mexico, Department of Psychology, 1 University of New Mexico, MSC 03 2220, Albuquerque, NM 87131.
authors.forename: Jane Ellen
authors.initials: JE
authors.lastname: Smith